Colorectal cancer: introduction

What is colorectal cancer?

There are several types of large bowel cancer and they are named after the cells that they develop from. Adenocarcinomas are the most common type of large bowel cancer. These tumours start in the lining of internal layer of the bowel. Other types of malignant tumours in the large bowel (such as lymphoma or carcinoid) are rather rare. These tumours are treated in another way than adenocarcinomas, and they often have other symptoms, too. This information is mainly about adenocarcinoma of the large bowel and rectum. Colon cancer and rectal cancer have a lot in common, and they are often referred to as colorectal cancer. However, there are some differences, particularly as regards their treatment.

What are the symptoms of colorectal cancer?

Colorectal cancer can have a variety of symptoms, although these might be almost imperceptible at very early stages of the disease.

  • A change in your normal bowel habit for no obvious reason, lasting longer than six weeks, should not be ignored. It can be diarrhoea or constipation, a feeling of not having emptied your bowel properly after a bowel motion, or difficult emptying. Thin or ribbon-like stools may be a symptom of advanced colorectal cancer.
  • Bleeding from the rectum or blood in the stools – the blood may be bright red or dark in colour – is another warning sign.
  • Slow, chronic blood loss within the body – such as from a colorectal cancer – can cause iron deficiency anaemia. Its symptoms may involve fatigue and weakness, sometimes also dyspnoea.
  • General abdominal discomfort, such as frequent gas pains, bloating, and/or cramps might also be symptoms of colorectal cancer.
  • Weight loss with no known reason might also be linked to colorectal cancer.
  • As colon cancer grows, several symptoms may appear. Bowel obstruction may produce symptoms of abdominal distension, pain, nausea, and vomiting.

It is important to bear in mind that all of the above-mentioned symptoms can be caused by non-malignant and less serious conditions. In particular, these involve haemorrhoids, infectious and inflammatory bowel diseases. However, colorectal cancer can develop over a long period without any symptoms, and manifest itself at an advanced stage of the disease. In case of any doubts, it is essential to see a GP, who should make arrangements for all necessary examinations.

Incidence of colorectal cancer in the Czech Republic

Colorectal cancer (CRC) is among the most commonly diagnosed cancers and its incidence rates in all developed countries are growing steadily. In international comparison, the burden of colorectal cancer in the Czech Republic is comparable to that in European countries on average. According to data from 2018, Czech male colorectal cancer incidence rates rank 14th in Europe, while female rates rank 19th in Europe. Each year around 7,200 patients are diagnosed with colorectal cancer in the Czech Republic, and the number of CRC deaths is almost 3,300.

colorectal cancer incidence and mortality in the Czech Republic

Figure 1: Colorectal cancer incidence and mortality in the Czech Republic.

colorectal cancer incidence in international comparison

Figure 2: Colorectal cancer incidence in international comparison.

More detailed information on colorectal cancer in the Czech Republic is available in the article Colorectal cancer: epidemiology and screening results.