Why Colorectal Diseases are Important?

Abstract

Copyright © 2012, Kowsar Corp.; Published by Kowsar Corp. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The shift of burden of diseases form communicable, highly transmissible diseases to non-communicable diseases is a tangible fact globally. In this shift some of the diseases have received appropriate consideration in prevention, diagnosis and treatment, while many of the others are neglected. Colorectal cancers (CRC) are among those which have received some attention in all of these aspects. CRC is the third most common diagnosis of cancer following lung and breast cancers and the fourth leading cause of cancer death following lung, stomach and liver (1). Although the burden is the highest in high income countries but there are many reports of increasing trend of this cancer in middle income countries (2-4). This cancer is among the cancers with the highest prediction for increase in the next decade in the world (5). CRC has the second largest share of new cancer diagnosis cost in the world (5). That is why it is not a surprise to see this disease among one of those issues with high allocation of resources for research and intervention. Nevertheless there are some ignored issues even in CRC. The issue of appropriate screening has recently gained some concern from economic viewpoint (6). Young patients with CRC are also another important concern. Although CRC is mostly diagnosed in sixth to eighth decades of life, but there are near 50% cases which are diagnosed before age of 50 or after age of 75 (7, 8).These two special groups are not well represented in none of the research studies and policies concerning CRC. Higher percentage of more advanced disease in these special groups with lower possibility of cure makes these groups even more important. The burden of disease in low and middle income countries is increasing and these countries usually do not have enough resources to combat this increasing trend. Constipation and anorectal diseases are among those annoying diseases with high prevalence but with inappropriate consideration in health systems globally. Most of the current consideration on these type of diseases are toward invasive surgical procedures or expensive and potentially harmful drugs, neglecting appropriate preventive measures and cost effective care (9, 10). The burden of these apparently benign but annoying diseases can not be overemphasized. At the same time, the increasing trend of sexually transmitted diseases along with change in sexual behavior has increased the burden of anorectal diseases substantially. All of these makes colorectal research an important agenda in health research. We need more focused research with the ability to change the health policies on these issues. At the same time we need better understanding of the pathophysiology of these diseases with more attentive basic science research to have a more scientific approach in prevention, diagnosis, treatment