Healthy lifestyle reduces colorectal cancer risk

Chadwick Boseman, who played the titular role in the movie Black Panther, died from colon cancer at the age of 43 on Aug 29. A day earlier, Shinzo Abe, 65, Japan's longest-serving prime minister, announced his resignation due to poor health, saying he suffered bouts of ulcerative colitis, a debilitating inflammatory bowel disease, for eight years but had managed to control it with regular treatment. But the latest check-up indicated the risk of the disease turning into colon cancer had increased.

Both pieces of news shocked many. More importantly, they raised concerns in China, where the risk of people developing intestine-related diseases including colorectal cancer has been rising.

As the largest "power station" and "waste treatment plant" in the human body, intestines handle on average 65 tons of food, roughly the weight of 12 elephants, during a person's lifetime.

The digestive tract, through which people get exposed to countless pathogens each day, also works with the immune system to guard against infections by potential invaders. Scientific studies have also confirmed a brain-gut link. Troubled intestines signal the brain, triggering emotional changes in a person, as the term gut feeling suggests.

In China, an estimated 30 million people have chronic intestinal conditions. And colorectal cancer is the third-most common cancer type and the fifth-leading cause of cancer-related deaths in the country, according to the Chinese National Central Cancer Registry. Each year, more than 370,000 Chinese people are diagnosed with colorectal cancer, and the incidence of the disease has been rising since the 1980s.

Behind the increase are factors such as lifestyle including body weight, diet, smoking, and the lack of exercise. A diet high in red meat－especially pork and beef－and processed meat such as sausages, salamis, ham and bacon heightens the risk of colorectal cancer.

Thanks to the rapid economic development, Chinese people's annual per capita meat consumption is expected to reach 29 kilograms by 2020, more than double of that in 1980, said a food and nutrition document issued by the State Council, China's Cabinet, in 2014.

The rate of increase in meat consumption is similar to the rising trajectory of colorectal cancer cases in China, with the incidence of the disease being higher in urban areas, according to Wang Xishan, who is associated with the Cancer Hospital of the Chinese Academy of Medical Sciences.

The rate of increase in colorectal cancer in the relatively rich eastern coastal region is higher compared with the western region, with Shanghai having the highest incidence.

Also, men in general are at greater risk than women due to relatively poor awareness and lifestyle. More alarmingly, early onset of colorectal cancer is increasing in China with about 15 percent of the patients being below 40.

However, this trend can be arrested.

Every individual should understand that personal health is linked to the future development of their families in particular, and society in general. As such, they should minimize the risks, especially by making some lifestyle changes.

Also, they should undergo regular medical checkups including colonoscopies and blood and stool tests after crossing 40.

In the United States, the incidence of colorectal cancer has been declining among older adults since 2000, largely due to increased screenings and public awareness. In 2018, 68 percent of Americans aged 50 to 75 had undergone screenings for colorectal cancer, according to the US Centers for Disease Control and Prevention.

Screenings help detect precancerous polyps which can be removed before they become malignant. Screenings can also detect early signs of the cancer, when treatment works best.

In China, however, the early diagnosis rate is only 7 percent, with 25 percent of the patients being diagnosed late－after the tumor has metastasized.

Therefore, the government should help raise public awareness and focus more on prevention. Industries and employers, too, can play an important part in prevention, by creating a healthy work environment and integrating screening programs into regular body check-ups for their employees.

After all, the national health plan "Healthy China 2030", which aims to improve people's health as a crucial part of the country's development strategy, also highlights prevention and increasing public participation to build a healthier China.

The authors are writers with China Daily.