Colorectal cancer was ranked first among Saudi males and third among Saudi females. There were 1729 cases of colorectal cancer accounting for 12.3% of all newly diagnosed cases in the year 2020 among Saudi nationals. It affected 966 (55.9%) males and 763 (44.1%) females with a male to female ratio of 126 to 100. 

              The age-Standardized Incidence Rate (ASR) was 12.4/100,000 for males and 9.6/100,000 for females. The five regions with the highest ASR in males were Riyadh at 18.3/100,000 Eastern region at 16.1/100,000, followed by Qassim at 11.7/100,000, then Tabuk at 11.4/100,000, and Makkah at 11.3/100,000. 

              In females, regions with the highest ASR were Riyadh at 16.5/100,000, followed by Qassim at 12.5/100,000, then Eastern region at 12.1/100,000, then Makkah at 9.2/100,000, and Jouf at 9/100,000 (Figure 3.2.3). The median age at diagnosis was 60 years in males (ranging between 17 and 98) and 58 years in females (ranging between 20 and 98).

• Early detection and decrease mortality of breast cancer

1- Raising the rates of diagnosis and early detection cancer at an early stage of the disease.

2- Reduce incidence of breast cancer mortality.

 The severity of colorectal cancer can vary based on the following factors:

1.   Fecal Immunohistochemical Test (FIT):

o   Target group: people at moderate risk of the disease (aged 45 - 75 years).

o   Result:

§  Negative: The FIT is repeated once a year.

§  Positive: The patient is referred to total colonoscopy. 

2.   Total colonoscopy:

o   Target group:

§  People at high risk of the disease.

§  People with a positive FOBT result.

o   Result:

§  Negative: The colonoscopy is repeated:

§  Once every 5 years for people at moderate risk of the disease.

§  Once a year for people at high risk of the disease.

§  Positive: The patient is referred to therapy.

The target population are categorized depending on their risk:

Average Risk Group: 

Age (45 - 75). 

-        No family history of CRC or personal history of polyps.

High Risk Group: 

• Family history of CRC.

- One first-degree relatives with CRC.

- Two or more second-degree relatives with CRC.

• Personal history of adenomatous polyp or inflammatory bowel disease.

• Genetic syndrome predisposing to CRC (HNPCC, FAP).

• Personal history of childhood cancer requiring abdominal radiation.

Treatment options depend on the following:

1.   Type of tumor.

2.   Place of tumor.

3.   Stage and spread of tumor.

4.   General condition of the patient.

5.   Having other diseases.

Methods of treatment:

1.   Surgical treatment.

2.   Chemotherapy.

3.   Radiation therapy.

4.   Immunotherapy.

Prevention:
Methods to prevent the colorectal cancer:

• Quit Smoking.
• Avoid obesity and maintain normal weight.
• Reduce fat, especially saturated fats.
• Eat fruits, vegetables and healthy food rich in fiber.
• Exercise regularly.

Referral: refer to different specialist services if needed: oncologist, nutritionists and dietitians, occupational therapist, psychologist, psychiatrists, and social workers.

Request FIT

 Request further evaluation if positive FIT: Total colonoscopy