Colorectal cancer may be written in our genes. Who is it most likely to threaten?

Cancer of the large intestine (colon) is genetic, which means that it develops because of the accumulation of genetic changes in cells. It can be hereditary, which means that it passes through the family from generation to generation. However, environmental factors are most often responsible for the development of the disease.

1. Cancer of the large intestine (colon) is one of the most common malignant neoplasms in Europe. In terms of mortality, it ranks third among all cancers
2. It is hereditary, but only to a small extent. Modifiable risk factors, such as a diet rich in red meat and fats, as well as alcohol abuse are more often responsible for its development.
3. It is estimated that 60-70 percent. all cases of colorectal cancer could be avoided through better nutrition
4. More information can be found on the Onet homepage.

Colon (large intestine) cancer – what do we know about it?

Hereditary cancers, including hereditary colon cancer, are genetic. However, not all genetic cancers are hereditary. Sometimes cancer changes are caused by environmental factors that can cause genetic mutations. In the case of colon cancer they include, among others smoking, drinking alcohol, and eating large amounts of red or processed meat.

About 1 in 30 colon cancer occurs in people with a genetically inherited condition called Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC).

Cancer, including cancer of the colon (large intestine), is caused by the proliferation of abnormal cells (called cancer cells) whose growth control mechanism has been damaged by genetic mutations, some of which may be hereditary and others caused by environmental factors.

Is colorectal cancer hereditary?

Cancer is genetic because it is changes in genes that cause cells to spiral out of control, leading to disease. However, “genetic” does not always mean “hereditary”.

Hereditary cancers are cancers that are passed on from generation to generation through genes. These cancers only cover a small fraction of colon cancers.

One of the best researched genetic causes of colon cancer is Lynch syndrome, which is also the most common risk factor. In people with mutations in Lynch syndrome, the risk of developing the disease is up to 80 percent. Lynch’s syndrome is also associated with the risk of other diseases, such as endometrial cancer, cancer of the small intestine, ovarian cancer, stomach cancer, pancreatic cancer or glioma.

People with a family history of colon cancer are more likely than others to carry genes that increase the risk of developing the disease. However, not all family cases of colon cancer are hereditary. Environmental factors such as a diet high in red meat and fats can increase your risk.

It is estimated that about 20 percent. colorectal cancer cases may be related to its family history. About 5-10 percent. cases are associated with Lynch syndrome. The remaining part is caused by modifiable environmental factors. It is estimated that 60-70 percent. all cases of colorectal cancer could be avoided through better nutrition.

Previously, it was suspected that carriers of mutations in the BRCA1 and BRCA2 genes, called breast cancer genes, may have a higher risk of colon cancer, but recent studies have not confirmed this. A 2020 meta-analysis published on PubMed, including nine studies, did not show an increased risk in this group.

Lynch syndrome

People with Lynch syndrome inherit mutations in their genes MLH1, MSH2, MSH6 i PMS2. They are called DNA damage repair genes because they code for proteins involved in mismatch repair (MJR) during the DNA replication process.

The fifth genetic change in Lynch syndrome is a gene deletion EpCAM. This gene, unlike the four previous ones, does not participate in the repair process, but is located next to the MSH2 gene, so that certain mutations in the EpCAM gene affect the activity of MSH2.

Lynch syndrome causes about 5-10 percent. all cases of colorectal cancer. In people diagnosed with colorectal cancer, 10-15% of other mutations that increase the risk of developing cancer are attributed to cancer development.

Other causes of colon cancer

About 70 percent. colon cancer cases are not related to heredity, the causes are described as “sporadic”.

The disease, one way or another, develops due to the accumulation of genetic mutations in the cells of the lining of the colon. It usually takes 10 to 15 years for these mutations to accumulate enough to lead to cancer. Environmental factors are largely responsible for the changes.

The main risk factors for colon cancer are:

1. aging
2. sedentary lifestyle
3. a diet high in fat and / or processed meat
4. drinking alcohol
5. use of tobacco
6. obesity or overweight

Ulcerative colitis and Crohn’s disease may also contribute to the development of colorectal cancer.

Colon cancer – symptoms

Cancer of the large intestine (colon) may be asymptomatic for a long time. Therefore, people with genetic or environmental risk factors for the disease should think about appropriate tests to diagnose possible risks as early as possible.

The most common symptoms of cancer include:

1. blood in the stool
2. feeling of incomplete bowel movements,
3. a change in the nature of your bowel movements, from constipation to diarrhea or vice versa
4. pencil stool
5. nausea, 
6. persistent diarrhea,
7. palpable tumor in the abdomen,
8. strong stomach ache,
9. strong abdominal cramps,
10. inability to pass stools
11. weight loss
12. weakness and lack of appetite.

Colon cancer – prognosis

The outlook for people with early colon cancer diagnosis is good. However, almost 80 percent. colorectal cancer is diagnosed in the late stages, the average 5-year survival rate is approx. 40%.

By the stages of colorectal cancer detection, the 5-year survival rate is:

1. early diagnosis of cancer – 90 percent,
2. neoplasm with involvement of adjacent organs – 72%,
3. cancer with metastases – 14%,
4. all degrees combined – 64%,
5. prognosis difficult to define – 35 percent

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