11 February 2024


Colorectal Cancer (CRC) is the second-leading cause of cancer-related deaths and the third most diagnosed cancer across the world. Colorectal cancer is the fifth leading cancer in India and continues to claim several lives every year.

Dr Mohinish Chhabra, Director, Gastroenterology, Fortis Hospital Mohali, through an advisory sheds light on colon cancer, importance of screening and how artificial intelligence (AI) helps detect the disease at the pre-cancerous stage.

Colon cancer & warning signs
Dr Chhabra
 said colon cancer affects the large intestine-colon and rectum. “Colon cancer usually starts in a benign growth – a polyp that arises in the innermost layer of the colon called the mucosa. Polyps that turn into cancer called adenomas and removal of these polyps can help prevent development of colorectal cancer,” he added.

Dr Chhabra further said that though colorectal cancer patients usually are asymptomatic, some signs could not be ignored. “Any recent change in bowel habits, constipation, rectal bleeding or blood in your stool, persistent abdominal discomfort, cramps, gas or pain, weakness or fatigue and a feeling that the bowel doesn’t empty should be addressed,” he added.

How screening helps
Stating that screening was the need of the hour, Dr Chhabra, added, “Colonoscopy is the only procedure that allows both the identification and removal of polyps. Removal of these polyps prevents up to 90% of colorectal cancer and with appropriate follow up, chances of death due to colorectal cancer is reduced.”

Artificial IntelligenceFortis Hospital Mohali is the first hospital in the country to offer Artificial Intelligence-assisted colonoscopy, which has helped to increase the adenoma detection rate. “It usually takes about 10-15 years for the polyps to become cancerous. The computer-aided detection (CADe) helps detect polyps/adenomas in the pre-cancerous stage. If detected in time, the polyps can be removed at an early stage. This prevents the cancer,” added Dr Chhabra.

Case studies
Dr Chhabra 
said a 56-year-old woman, who was absolutely asymptomatic, visited Fortis Mohali to get herself screened on the insistence of her friend, who had suffered from colon cancer. AI-assisted colonoscopy revealed that the woman had a Laterally Spreading Tumour (LSTs) in her right colon. The Patient underwent colonoscopic removal and thus, the cancer was prevented.

Screening helped detect the pre-cancerous lesions. We removed the pre-cancerous polyps from the woman’s right colon and hence the cancer was prevented. Had she not undergone screening, she would have never found out that the lesion had the potential to grow into a malignant cancer,” addedDr Chhabra.

In another case, a 68-year-old man — who was suffering from chronic constipation for the past nearly 20 years — approached Dr Chhabra recently after his symptoms exacerbated. The patient had been on homeopathic medication from the last five months but his symptoms had not subsided. The digital examination revealed a growth deep in the patient’s rectum.

Discussing the case, Dr Chhabra, said, “This was an unfortunate condition as colon cancer is a preventable cancer. Had the patient undergone screening for colon cancer about 10 years ago, the cancer could have been easily prevented by removing the polyp from which the cancer arises.”


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