5 symptoms of colorectal cancer in women

[Mise à jour le 17 février 2023 à 10h41] Every year in France, 20,000 women find out they have colorectal cancer (out of a total of 43,000 cases, according to the National Cancer Institute). “It is second most common cancer in womenbehind breast cancer” tells us Dr. Mathilde Soule, digestive surgeon at the Hôpital des Peupliers in Paris. 90% of colorectal cancers are diagnosed after the age of 50. This cancer expands from the cells that line the inside of the colon or rectumwhere are formed polyps which are small growths. “It’s necessary about ten years for benign polyps to develop into cancerous polyps (which is not systematic, editor’s note)“says Dr. Soule. Like all cancers, the earlier colorectal cancer is detected, the better the chances of recovery. Healed from colon cancer diagnosed in 2019, the actress Clémentine Célarié released the book “The forbidden words” in 2021 to talk about it: “I don’t want to get into the taboo thing. (…) Don’t talk about a disease (…) it encloses the beings who have this disease in something that worsens the disease (…) for me, it is absolutely necessary to speak about it! It’s something human and, also, it counteracts the fear of catching it!“ she explained on the show What an era! on France 2 Saturday February 11, 2023.

What is the age at risk for colorectal cancer in women?

Colorectal cancer is disease of the elderly and globally, 90% of colorectal cancers are diagnosed after the age of 50, especially from the age of 70. In both women and men, three levels of risk are defined:

• The people who have over 50 have an average risk.
• People suffering from an inflammatory disease of the digestive tract (Crohn’s disease, ulcerative colitis…), those who have a personal or family history of colorectal cancer and smokers have high risk.
• People with a genetic disease (Lynch syndrome or familial adenomatous polyposis) have very high risk.

5 colorectal cancer symptoms to worry about

“Colorectal cancer is cancer slowly evolving and not very symptomatic : the symptoms are not very specific and only appear when the disease has taken hold“, specifies our interlocutor. The symptoms suggestive of colorectal cancer can be the following.

1. Blood in the stool: At the beginning of its development, the polyp is simply an outgrowth in the digestive mucosa and does not cause any symptoms. Over the years, the polyp can degenerate and evolve into a cancerous adenoma, which weakens the digestive mucosa. The latter thus presents lesions and tends to bleed more in contact with food. THE blood maybe in the stool light red or on the contrary very dark red. “The presence of blood in the stool is a warning symptom And should push to see a doctor, insists the expert. Women must be particularly vigilant: most of the time, the 50-year-old woman no longer has her period. However, she may have post-menopausal bleeding. And it can delay the diagnosis : the woman may have the impression of having vaginal bleeding when it is blood in the stool“, points out Dr. Soule.

2. Abdominal pain : “They are related to local inflammation of a weakened and more sensitive digestive mucosa“, explains Dr. Soule. Consequence: the transit will be modified, bloating and abdominal cramps may occur. Abdominal pain is a symptom of many pathologies of the entire abdomen. However, abdominal pain persistent and that appear for no reason apparent should lead you to consult a doctor. Only the doctor’s clinical examination, the associated symptoms and the additional examinations (complete assessment, abdominal ultrasound, sometimes a scanner) make it possible to make the diagnosis and to propose appropriate care.

3. A transit that changes: “A transit that had been regular for years and which changes in about 3 months represents a warning symptom. This change in transit may be accompanied by functional colopathy or other functional intestinal disorders“, indicates the specialist. Do not hesitate to consult a gastroenterologist in case of unusual transitthat is, upon the onset of diarrhea, prolonged constipation, or alternating between the two, stools that appear narrower (ribbon or pencil-like) than usual and if the frequency of your stool changes suddenly.

4. Weight loss : “The presence of a polyp can accelerate transit and cause diarrhea“, emphasizes Dr. Soule. Acute diarrhea is characterized by stools that are very rich in water, thus leading to rapid weight loss. This symptom is absolutely not specific to colorectal cancer and can reveal many other digestive problems or not. However, when the weight loss is significant and persistent, you must consult a doctor, who can prescribe tests to find the cause of your weight loss.

5. Permanent fatigue : Significant fatigue that does not improve at rest may be suggestive of colorectal cancer. It is often linked to weakness and deterioration in general healthbecause of the development of the disease which can be very trying.

What are the differences with the symptoms of colorectal cancer in men?

Men have much the same symptoms, although the symptoms of functional colopathy are a little more specific to women. In effect, “hormonal changes during menopause lead to a slowing of transit and sometimes more significant bloating in women”explains the specialist.

When to worry? What to do ?

This test makes it possible to diagnose benign tumors before evolving into cancerous lesions.

If you have any of these symptoms, consult your doctor as soon as possible. Moreover, since colorectal cancer is not very symptomatic, it is essential to get regular screening for colorectal cancer from the age of 50, even in the absence of risk factors or symptoms. From 50 to 74 years old, a letter is sent every two years as part of the national organized screening program. This letter invites people to consult their doctor so that he gives them a Free FIT test to do at home and explain to them how to use it. This is a very easy to use immunological test which allows you to look for the presence of blood in the stool. The attending physician may also prescribe this test in the event of suspicious symptoms. The results are sent a fortnight later, to the patient as well as to his attending physician. “Unfortunately, this test remains very little done: about a third of patients over the age of 50 do so. Which is a shame because it would allow very early diagnosis of benign tumors before they develop into cancerous lesions.“, regrets the digestive surgeon.

Survival prognosis

The earlier the disease is diagnosed, the better the prognosis for survival. If the disease is localized in the wall of the digestive tract (stages 0, 1, 2), the 5-year survival is 90% whereas if the disease invades the lymph nodes (stages 3 and 4), the 5-year survival is by 50%.

Thanks to Dr Mathilde Soule, digestive surgeon at the Hôpital des Peupliers in Paris.