Insidious Intestines
Colon cancer. Scary stuff eh? Chances are you know someone or someone who knows someone who suffered from colon cancer. It’s something in the back of my mind given that it ain’t all that easy to do a self colon examination. Even if some people might say I have my head up where the sun don’t shine. So what’s the big deal? It’s the third most common diagnosed cancer and third most common cause of death by malignancy in both male and female according to 2022 data from the American Cancer Society
Ok, have we made no improvements in dealing with colon cancer? We have, over the last 40 years the rates of death have dropped 56% which is pretty great (understatement for those with loved ones who’ve suffered from colon cancer). This is such a huge topic but I’m only going to cover one article from a Medscape email I received
Rates of decline for colon and colorectal cancer (I’ll now call them CRC) have slowed between 2011 and 2019. This is driven by an increase in the rates of colon cancer in those under 55 years old. The number of CRC cases diagnosed at an advanced stage (metastasized) rose to 60% in 2019 from 52% in 2000 and 57% in 1995. What gives? The authors hypothesis is that an increasing in body weight generally, inactivity, and poor dietary choices have driven this trend. Of course there are other risk factors but these were the top three.
We are also screening more and more for cancers and it makes me think of one of my favorite books The Emperor of All Maladies by Siddhartha Mukherjee. Fantastic, well worth your time. In the book, there are several sections about the rising rates of cancers being diagnosed. Dr. Mukherjee asks if this is based on increased and more effective screening versus increasing incidence of cancer overall. In each study I found, as well as the afore mentioned book, it is accepted that some of the increase has been from more screening. However, it does not seem to account for the rate of increase.
I find it more likely that it is the combination of more screening and an increasingly obese and sedentary population. Other reasons are probably present however I do not feel like writing into the wee hours. Want to hear a depressing fact or two? In the United States as of 2020 41.5% of adults are obese, 9.2% are severely obese, and in Europe over 60% of adults are overweight or obese as of 2022. Globally, 31 percent of those above 15 years old do not get the recommended daily amount of activity and Americans spend 55% of their waking time sedentary. Yikes. Why do I bring this up? Obesity and a sedentary lifestyle are linked to myriad disease states. Most relevant here of course in CRC, but many people think of COVID-19, hyperlipidemia, CV dysfunctions.
The answer to end all answers is!...... I dunno, move? It isn't that easy for sure but it is an area for anyone interested in healthcare to break into. The amount of chronic disease in America is large, 6 in 10 per the CDC. How do we help those people? I am not just speaking to healthcare folks. How do you take care of your dad, or aunt, or cousin who is going down an unhealthy road? Personally, that is a draw towards primary care. How can I make a lasting impact on this person? There is a lot to cover about CRC but right now focus on what you can change. Smoking, diet, activity, alcohol. That is all I have to say right now. I think these will be one every 2-3 days and I just got a cheap mic in to try my hand at a podcast. Maybe. I've always been told I have a face for radio. Peace y'all.
References
Adult Obesity Facts from the CDC updated May 2022.
Chronic Diseases in America from the CDC updated December 2022.
Image of mucinous adenocarcinoma of the colon from the Journal of Gastrointestinal Oncology Volume 3, Number 3 2012.
Obesity, Race/Ethnicity, and COVID-19 from the CDC updated September 2022.
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