Problem of colorectal cancer in India and issues related to management

Colorectal cancer (CRC) in India ranks amongst the lowest in comparison to most parts of the world. However, the sheer population of the country and increasing urbanization, coupled with greater awareness and scope of detection, has resulted in a gradual increase in numbers to the point that it ranks amongst the commonest cancers in India. This review discusses the relevance of specialization in CRC surgery in India and also important aspects of multidisciplinary care such as advances in chemotherapy and radiotherapy. This article also deals specifically with the problem of rectal cancer in young Indians. Furthermore, the impact of minimal access CRC surgery and cutting edge issues in CRC surgery such as approach to complete responders after neo-adjuvant treatment in rectal cancer, concepts in sphincter preservation, and dealing with metastatic CRC are also addressed. Lastly, modern molecular biology with a clinical relevance and modern surgical approaches such as TEMS and TAMIS are also discussed.