On July 27th, the news that renowned mystery novelist Keigo Higashino passed away due to colorectal cancer once again brought this disease, which is often low-profile yet highly prevalent, to the forefront of public attention and trending searches.
Among numerous malignant tumors, colorectal cancer has a very special nickname - "dumb cancer". Many people, upon hearing this name, may mistakenly believe that it is less dangerous, develops slowly, and is not a cause for much concern.
On the contrary, "dumb cancer" is not dumb at all; it is just the best at "hiding".
Unlike rapidly progressing acute cancers, colorectal cancer has a protracted course and a very long window of opportunity. However, precisely because of this, countless people are deceived by its "slow pace" and end up with advanced-stage disease.
Why is colorectal cancer called "stupid cancer"?
Professor Zhao Xinkai, Vice President of Hainan Chengmei Hospital and an expert in gastroenterology, explained that the so-called "slowness" does not mean low malignancy, but rather that its carcinogenesis process is very regular and progresses extremely slowly.
The vast majority of colorectal cancers follow the same evolutionary pathway:
Benign intestinal polyps → slow proliferation → dysplasia → malignant intestinal cancer
This entire malignant transformation cycle can last for 5 to 10 years, and even longer for some patients.
In other words, it gives you a full ten years to discover and prevent it.
Unfortunately, due to the absence of any pain or discomfort in the early stages, the vast majority of people directly overlooked this "opportunity for self-rescue".
Don't ignore these physical signals. If they occur, seek medical attention immediately
Zhao Xinkai reminded that early-stage intestinal cancer often presents no symptoms. If any of the following abnormalities persist for more than 3 weeks, one should not delay seeking medical attention by mistaking them for hemorrhoids or gastroenteritis.
Sudden changes in bowel habits: alternating diarrhea and constipation without any apparent triggers, sudden increase or decrease in bowel movements, and a constant feeling of incomplete bowel movements and anal descent.
Abnormal stool shape and color: The stool becomes thinner and flatter, with grooves on the surface; the blood in the stool is dark red, mixed with mucus and pus, which is different from the bright red dripping blood of hemorrhoids.
Abdominal discomfort: recurrent lower abdominal dull pain, abdominal distension, and discomfort that does not improve after defecation.
Unexplained systemic symptoms: rapid weight loss without deliberate weight reduction, chronic fatigue and dizziness, and iron-deficiency anemia are typical manifestations of chronic intestinal blood loss. Many people who experience hematochezia assume it is hemorrhoids and self-medicate, masking the condition. By the time a diagnosis is confirmed, it is often in the middle or late stages. This is also the main reason for delayed diagnosis of bowel cancer in China.
Colonoscopy: the "gold standard" for colorectal cancer screening
"The most effective means to deal with 'stupid cancer' is colonoscopy screening, and there is no alternative solution," Professor Zhao Xinkai emphasized. Fecal occult blood and fecal DNA testing are only used as preliminary screening, and cannot directly visualize the entire intestinal tract. Colonoscopy is the gold standard for diagnosis.
Screening cycle standardization
General population: starting from the age of 45, colonoscopy should be performed every 5-10 years. If the results are normal throughout the entire procedure, the interval can be extended to 10 years, with annual fecal occult blood testing added;
High-risk population: Screening should begin at the age of 40, with colonoscopy rechecked every 3-5 years;
If you experience discomfort such as bloody stool or abnormal bowel movements, don't wait for a certain age to undergo colonoscopy
Currently, painless gastroscopy is widely performed in clinical settings, conducted under short-acting intravenous anesthesia throughout the entire process. Patients experience no discomfort such as nausea, abdominal distension, or abdominal pain during the examination, and the entire procedure can be completed while they are asleep.
These groups of people have a doubled risk of bowel cancer and need to undergo screening in advance
In accordance with the "Colorectal Cancer Screening and Early Diagnosis and Treatment Plan (2024 Edition)", it is recommended that high-risk individuals initiate colonoscopy screening earlier.
For the general population aged ≥45 years, the incidence rate increases significantly with age, making it the primary high-risk factor;
Individuals with a history of colorectal cancer or adenomatous polyps in their immediate family members have a 2-5 times higher risk of developing the disease compared to the general population. It is recommended to initiate screening at the age of 40;
Patients with long-term chronic enteritis and ulcerative colitis;
People who have a high-fat and high-protein diet all year round, eat few vegetables and fruits, sit for long periods without moving, are obese, and smoke and drink for a long time;
People who have a long-term history of hematochezia and have a habit of eating pickled, smoked, and processed meat products all year round.
Prevent colorectal cancer in an all-round way by following these four points
Adjust diet structure: Intake 25-30g of dietary fiber daily, consume more leafy greens, whole grains, mushrooms, and fresh fruits; reduce intake of processed meats such as red meat, sausages, and bacon, limit fried, smoked, and high-salt marinated foods, and drink plenty of water to soften stool and reduce intestinal irritation.
Abandon unhealthy lifestyle habits: quit smoking and limit alcohol consumption, as both can doubly irritate the intestinal mucosa and accelerate the growth of polyps; avoid prolonged sitting, and ensure at least 30 minutes of aerobic exercise such as brisk walking or jogging every day to control weight and reduce abdominal obesity.
Pay attention to underlying intestinal diseases: people with recurrent hematochezia and enteritis should undergo regular follow-ups and seek timely treatment, rather than self-medicating to mask symptoms; those with a family history should proactively record their relatives' medical histories and communicate with gastroenterologists in advance about screening plans.
Incorporating colonoscopy into routine physical examinations: This is the most crucial step. Although colon cancer is often referred to as a "dumb cancer," it is most vulnerable to regular colonoscopy screenings. By undergoing timely examinations, cancer can be nipped in the bud.
Expert reminder
Although the incidence rate of colorectal cancer remains high, it is also the type of malignant tumor with the lowest prevention cost and the highest early cure rate. Do not miss the golden opportunity for complete eradication by neglecting intestinal screening or fearing colonoscopy. From now on, pay attention to your intestinal health and proactively undergo regular screenings.
Expert Introduction
Zhao Xinkai, Chief Physician
Vice President, MD
Professor, Master's Supervisor
Gastrointestinal Oncology Endoscopy and Diagnosis Department, Gastroenterology Department
The director of the Endoscopy Integrated Diagnosis and Treatment Center also serves as an expert in the International Department
High-level talents in Hainan Province
Winner of the May 1st Labor Medal in Hainan Province
Medical expertise
Proficient in various complex and difficult techniques of digestive endoscopy, such as ERCP and related techniques, ESD and related techniques, endoscopic ultrasonography, PEG, capsule endoscopy, small intestinal endoscopy, and other endoscopic diagnostic and therapeutic techniques.