What is colorectal cancer?

Colorectal cancer is the third most common cancer affecting both men and women in Cyprus. It develops from the cells lining the inner surface of the colon or rectum, most often from small benign polyps that may gradually become cancerous over several years. This is why early detection—even before symptoms develop—can save lives.

Symptoms

In its early stages, colorectal cancer often causes no symptoms. As the disease progresses, symptoms may include:

• Changes in bowel habits (persistent diarrhoea or constipation, alternating diarrhoea and constipation, changes in stool shape)
• Blood in the stool (either visible or detected only by testing)
• Anaemia and persistent fatigue
• Unexplained weight loss
• Abdominal pain, usually in more advanced stages

Diagnosis

The investigation of choice for diagnosing colorectal cancer is colonoscopy with biopsy. If cancer is confirmed, further tests are performed to determine the stage of the disease and plan the most appropriate treatment. These investigations include CT scan of the chest, abdomen and pelvis and MRI of the pelvis (for rectal cancer).

Since May 2025, the national colorectal cancer screening programme in Cyprus, offered through the General Healthcare System (GeSY), has included a faecal immunochemical test (FIT) every two years for men and women aged 50–74 years. Individuals with a positive FIT result are referred for a colonoscopy.

Colonoscopy is generally recommended from the age of 50 years (or earlier for individuals with an increased risk) to allow prevention and early detection of colorectal cancer.

Treatment

Surgery

Surgical removal of the affected segment of the colon or rectum, together with the surrounding lymph nodes, is the main treatment for colorectal cancer. In the majority of patients, surgery can be performed using a laparoscopic (minimally invasive) approach.

Chemotherapy and Radiotherapy

Additional treatment depends on the stage and location of the cancer and may include:

• Neoadjuvant chemoradiotherapy before surgery for locally advanced rectal cancer
• Adjuvant chemotherapy after surgery to reduce the risk of recurrence in selected patients
• Systemic treatment for metastatic disease, including chemotherapy, targeted therapy, and immunotherapy, where appropriate

The treatment plan is always discussed within a Multidisciplinary Team (MDT) meeting, involving specialists such as: General/Colorectal Surgeon, Medical Oncologist, Gastroenterologist, Radiation Oncologist, Pathologist, Radiologist. This collaborative approach ensures that every patient receives an individualised treatment plan based on the latest international guidelines and their specific clinical needs.