Doctor seeing increased colorectal cancer cases

Radiation oncologist Dr Praveen Sharma is encouraging Jamaicans to screen for colorectal cancer, as it continues to be an increasing cause of death on the island.

"Colorectal cancer is one of the third most common cancers in Jamaica, in terms of incidence, if we take [into account] both males and females, and it is also the third leading cause of mortality. So, after prostate, after breast, it is colorectal cancer that is killing most patients," Sharma told JIS News. He noted that, based on recent data, there are 800 to 900 new cases of colorectal cancer detected yearly.

"Earlier, it was very rare to see rectal cancers in my clinic, but now it is almost one or two cases every week ... my radiation department receives almost one patient for colorectal cancer per week," he said. Sharma, who is head of the radiotherapy department for the National Cancer Treatment Centre at Cornwall Regional Hospital, pointed out that the illness has become one of the "priority cancers" and the health ministry has outlined screening guidelines among six other priority illnesses, namely hypertension, diabetes, depression, prostate, breast and cervical cancers. Sharma also informed that colorectal cancer is now included in the National Health Fund subsidy.

Colorectal cancer starts in the colon or the rectum. It can also be called colon cancer or rectal cancer, depending on where it starts. While some persons may be asymptomatic, symptoms of colorectal cancer may include a change in bowel habits, blood in or on your stool, diarrhoea, constipation, or feeling that the bowel does not empty all the way. Other symptoms may include abdominal pain, aches or cramps that do not go away, and weight loss.

Sharma noted that persons from age 45 to 74 are typically at risk of getting the disease. Persons that have a family history of the illness, regardless of their age, are encouraged to screen for the illness, as they may be genetically predisposed to develop colorectal cancer.

"The median age group [of persons who get the illness] is about 63 in Jamaica, but more and more now we are seeing that the trend is shifting to younger patients. In fact, there is data which says 20 per cent of our cases are less than 50 years of age," Sharma noted.

"If you have a family history, then screening can start as young as 12 years of age," he added. Other risk factors for colorectal cancer include obesity, smoking, drinking alcohol, and a diet which consists of less fibre and more fats. Sharma pointed out that there are a few screening tests that are done to detect the illness.

"One is what we call a stool-based test, that is the easiest and most commonly available. There are three types of stool-based test, but we use only two. One is called FOBT, which is faecal occult blood testing, which just means that you test the sample of stools for the presence of blood, basically the haemoglobin that is present in the blood," he informed.

"So, the haemoglobin component is tested by using certain chemicals on the stool sample, and we can detect if there is any bleeding happening or not. If it comes positive, then the patient is referred for further evaluation to rule out colorectal cancer," Sharma said.

The faecal immunochemical testing (FIT) is also used to detect colorectal cancer, as well as the FIT deoxyribonucleic acid test. Nurse in the Cornwall Regional oncology department, Sherice Allen, said that the "gold standard" for screening would a be colonoscopy, which should be done every eight to 10 years.