NCD Watch

Fighting Colorectal Cancer

12 Mar 2020 (Thu)

Fighting Colorectal Cancer Colorectal cancer is a major public health problem. In Hong Kong, colorectal cancer has become the commonest cancer and the second ‘cancer killer’. According to the Hong Kong Cancer Registry, the number of newly diagnosed colorectal cancer increased from 2 022 in 1990 to a record high of 5 635 in 2017.

Prevention is better than cure. For colorectal cancer, primary prevention is of utmost importance. Primary prevention refers to intervening before the disease occurs through measures such as altering risk behaviours known to be associated with the disease. As many of the risk factors of colorectal cancer are lifestyle-related and are hence modifiable. Studies have shown that leading a healthy lifestyle can markedly lower the risk of colorectal cancer.

To reduce colorectal cancer risk, the Government’s Cancer Expert Working Group recommends members of the public to pursue a healthy lifestyle that includes:-

  • Increase intake of food with high dietary fibre, such as fruit and vegetables, whole grains and pulses;
  • Reduce consumption of red and processed meat, such as sausage, ham, bacon and luncheon;
  • Have regular exercise. For adults, perform at least 150 minutes of moderate-intensity physical activities or equivalent amount per week;
  • Maintain a healthy body weight and waist circumference. For Chinese adults in Hong Kong, aim for a body mass index between 18.5 and 22.9, and a waist circumference of less than 90 cm (about 36 inches) for men and less than 80 cm (about 32 inches) for women;
  • Abstain from or quit smoking; and
  • Avoid alcoholic drinks.

Other than primary prevention, secondary prevention involves screening individuals without symptoms in order to detect disease or identify individuals who are at increased risk of disease for early intervention. It is noteworthy that colorectal cancer usually begins as a polyp that may take more than 10 years to progress into cancer. By removing colorectal adenoma in the course of colonoscopy can prevent them turning into cancer, and thus colorectal cancer is one of the few cancers that can be effectively prevented through organised and evidenced-based screening. In some countries (e.g. Australia, Canada and the United Kingdom), population-based colorectal cancer screening has shown to be effective in reducing the incidence of colorectal cancer.

In Hong Kong, the Government launched the Colorectal Cancer Screening Programme (CRCSP) as a pilot programme in September 2016 and regularised in August 2018, aiming to reduce the burden arising from colorectal cancer. Using a public-private partnership model, the programme subsidises asymptomatic average-risk (i.e. without significant family history of bowel diseases) Hong Kong residents aged between 50 and 75 to undergo screening tests in private sector to prevent colorectal cancer.

Eligible persons (i.e. Hong Kong resident aged 50–75) are strongly encouraged to join the CRCSP for prevention of colorectal cancer. For more information, public are welcome to call the enquiry line 3565 6288, which is manned by trained staff to answer enquiries during office hours; or visit the thematic website at www.colonscreen.gov.hk for the list of enrolled doctors and information of CRCSP.