With the gradual improvement of our people’s living standard, the diet is also gradually westernized, the intake of high-calorie, low dietary fiber food more and more, coupled with the daily “pampered” lack of exercise, which leads to intestinal cancer, this lifestyle-related “disease of the rich and famous”. The incidence rate is increasing year by year.

By the end of 2020, the incidence rate of colorectal cancer in China has ranked the top three, and the mortality rate ranks fifth. Survey data show that the incidence rate and age of onset of intestinal cancer in China are currently showing a “double rising” trend. Starting from the age of 55, the risk of colorectal tumor incidence continues to go up, and generally reaches its peak in the age group of 80-84. In Shanghai, for example, more than half of the colorectal cancer cases are in people over 70 years old; and in patients over 75 years old, colorectal tumors continue to climb at a rate of 3.91% per year.

The incidence of colorectal cancer in the elderly is hidden In an interview with the reporter, Huang Rui, a member of the tumor metastasis professional committee of the Chinese Anti-Cancer Association and a professor of colorectal oncology surgery in the Second Hospital Affiliated to Harbin Medical University, pointed out that the elderly is a susceptible group of people of cancer itself, and the incidence of its malignant tumors is significantly higher than that of other groups. As the proportion of the elderly population increases, the number of new malignant tumors and the number of long term survivors will also rise, which poses a serious challenge to the allocation of medical resources, especially for the elderly to meet their specialized diagnosis and treatment, rehabilitation and care needs. At the same time, clinicians are required to continuously improve their medical standards and strive for early detection and treatment, so that elderly colorectal cancer patients can have a long-term survival rate and a better quality of life after surgery.

Prof. Huang said, due to the decline of physiological functions of elderly patients, slower reaction, slower growth of colorectal tumors, lack of specificity of early symptoms, most of the elderly people’s initial clinical manifestations are not obvious, and often have entered the middle and late stages when they seek medical treatment. Generally speaking, the common first symptom of intestinal cancer patients is change of bowel habit and bloody stool, mucus stool, followed by intestinal obstruction, abdominal mass, abdominal pain and distension, diarrhea, etc. With the increase of age, the incidence of abdominal mass and intestinal obstruction of elderly patients with colorectal cancer increases, and they have to be extra vigilant to these “clues”.

Early clinical symptoms should not be ignored. According to foreign reports, colon cancer patients over 75 years old, their tumors are mostly located in the right half of colon, and the incidence rate of proximal colon cancer is more significant in patients older than 75 years old. The research data in China shows that colorectal cancer in the elderly is still the highest incidence in rectum and sigmoid colon, followed by right colon, transverse colon and descending colon. Relevant studies also show that the size of colorectal tumors in the elderly is concentrated around 2-5 cm, followed by those larger than 5 cm, with fewer cases of tumors smaller than 2 cm. At the same time, clinical ulcerative type is more common, followed by bulging type; infiltrating type and other types are relatively rare.

In view of the above situation, Prof. Huang reminded that elderly patients with mild symptoms in digestive tract should be carefully asked about their medical history and physical examination. If there are bloody stools, mucous blood stools, or change in bowel habit, outpatient clinic and clinicians should attach great importance to it and give appropriate examinations in time, including anal fingerprinting, total colonoscopy, abdominal CT, etc., in order to avoid missed diagnosis and misdiagnosis; and at the same time, they also need to increase the efforts of popularization of science to let the general public know and understand colorectal cancer. At the same time, we should also increase the publicity of science to let the public understand and recognize colorectal cancer, and see doctors in time if there is any abnormal condition.

Prof. Huang Rui analyzed and pointed out that the high percentage of stage I to II colorectal cancer patients in senior age and the predominance of middle and high differentiated cancers indicate that their malignant degree is relatively low and there is a better prognosis, which, to a certain extent, provides favorable conditions for radical resection and obtaining better curative effect. At present, China’s medical technology and level is very high, the age of the elderly has long been no longer a constraint for surgery, effective control of preoperative comorbidities, perioperative monitoring and treatment can effectively reduce the incidence of postoperative complications and surgical deaths, so that the elderly can enjoy the “second spring” after surgery.

Changing bad habits is crucial, so how can we avoid colorectal cancer? Prof. Huang cautioned that, in terms of lifestyle habits, to prevent colorectal cancer, it is important to “keep your mouth shut and keep your legs open”, which are crucial, as genetic susceptibility genes cannot be modified. However, it can be prevented by changing poor lifestyles. According to the global aging and adult health research report, China’s elderly population, 70-79 years old smoking rate of 30.6%, drinking rate of 18.8%, inadequate intake of fruits and vegetables 41.8% (80 years old and above, 58.0%), overweight rate of 29.0%, obesity rate of 5.4%. These factors are mostly the result of the accumulated lifelong habits of the elderly, who must stop smoking and limit alcohol consumption, lose weight, control blood sugar, and consume more fresh fruits and vegetables.

Among them, we should eat more vegetables rich in vitamin C, such as cabbage, spinach, celery and broccoli, etc.; we should also consume dragon fruit, kiwi, oranges and other fruits that are good for laxative, so as to effectively reduce the time of fecal carcinogens coming into contact with the intestinal mucosa, and to prevent the occurrence of colorectal cancer. Professor Huang also cautioned that life needs to be prohibited spicy, cold, sour and astringent products; high fat, high protein, low fiber and smoked, deep-fried, pickled food must also be respected, in order to avoid increasing the burden on the gastrointestinal tract, while not allowing nitrites to enter the human body after the formation of carcinogens.

In daily life, the prevention of constipation can effectively reduce the risk of colon cancer, so many people have a little bit of difficulty in the stool on the use of laxatives to solve the problem, this practice is also not desirable. “Although laxatives can help promote gastrointestinal motility and facilitate defecation, long-term abuse will cause abnormalities in gastrointestinal motility and destroy normal intestinal flora; at the same time, it will create a dependence on laxatives, which will lead to more serious constipation once the medication is stopped. Prof. Huang pointed out that laxatives can only be applied when there is special constipation or obstruction, or before gastroenteroscopy, which is a temporary emergency drug and cannot be taken at will.

Finally, Prof. Huang Rui suggested that the elderly friends must enhance the awareness of regular medical checkups, people over half a hundred, if possible, strive to do a comprehensive body checkup every year, especially every two years or so for colonoscopy screening, such as the discovery of rectal polyps or pre-cancerous lesions, to facilitate timely treatment.