Statement by prof. dr hab. Jarosław Reguła from the Department of Gastroenterology, ONCOLOGY CENTER
in Warsaw.
Causes of colon cancer
What do we know about the formation of colon cancer? In most cases this tumor is formed on the basis of benign polyps of the colon. It is believed that this is done by gradual genetic transformation of adenomatous polyps. The transformation of adenoma into cancer occurs through a series of mutations in the genes that are most important for its development. The process takes on average about 10 years.
Is Colon Cancer More Threatening to Women or Men?
It is said that the cancer of the large intestine is a disease of "equal opportunities" that affects men and women with the same frequency. In Poland, it is currently the second most frequent cause of deaths from malignant neoplasms in both women and men. (after breast cancer (women) and lungs (men)).
Which people are particularly at risk of developing this cancer?
High risk of colorectal cancer is characterized by people with first-degree relatives below the age of 50 who have been diagnosed with colon or rectal cancer; people with chronic inflammatory bowel disease; family polyposis syndrome; history of colon or rectal cancer or advanced rectal or colorectal adenoma.
Does the risk of colon cancer depend on your age?
Yes, the risk of getting sick starts to increase significantly after the age of 50. The peak of the incidence of this cancer appears after the age of 60.
Does a specific diet and lifestyle affect the risk of getting sick?
There are rational assumptions about the impact of diet and lifestyle on the risk of colon cancer, although there is currently no scientific evidence for this. Despite this, it seems that you should avoid the risk of improper diet - eg excess of animal proteins (meat) and saturated fats and a high calorie diet, not balanced by intense physical effort. Conversely, a low-calorie diet, especially composed of foods rich in plant fibrils, (vegetables and fruits) seems to reduce the risk of cancer. Risk factors also include - excessive body weight and presumably smoking tobacco drinking. Conversely, physical effort and low body weight reduce the risk of disease.
Are there drugs that reduce the risk of getting sick?
Since the collection of evidence to reduce the risk of developing colon cancer through prophylactic dosing of acetylsalicylic acid, hope for cheap prophylaxis has increased. Unfortunately, due to the risk of health-and-life complications - ie bleeding and perforation of the stomach and duodenum - no recommendation for prophylaxis has been made. It should be noted that this is not about acetylsalicylic acid microdiscers - often used chronically in preventive prophylaxis - but about daily intensive pharmacotherapy with doses not smaller than 350 mg.
How should people from these high-risk groups of colon cancer be monitored?
Special individual diagnostics and frequent follow-up examinations are necessary, usually with the necessity of periodic colonoscopy.
Available recognition methodscolon cancer are:
♦ palpation examination, through the rectum,
♦ examination of faecal occult blood
♦ rectoscopy and biopsy,
♦ colonoscopy with a biopsy,
♦ rectal enema with double contrast
Are free mass diagnostic tests available for people at risk?
Yes. The basic diagnostic tool for these tests is a colonoscopy performed once every 10 years. As many well-known doctors emphasize, such as Dr. Scott K Kuwada from the USA, prof. dr med.Marek Nowacki, and others - colonoscopy is the best and currently the cheapest way to conduct screening tests. This may seem like a paradox, but the total costs of the annual examination of faeces against occult blood in comparison with the so-called the next colonoscopy is a more expensive method.
What is a colonoscopy?
Colonoscopy is a modern method of non-invasive diagnostics, which, thanks to the combination of optical visual technique and micro-surgery, allows to detect cancer at an early stage (including biopsy and removal of adenomas, which are pre-cancerous, occurring in about 20% of people over 50 years of age. so an ideal way to conduct screening tests.
Why are screening tests necessary for the above-mentioned risk groups, including people over 50?
The percentage of people who survived the surgery after more than 5 years depends mainly on the stage of cancer at the time of starting treatment. Currently in Poland it is only in the range of 21.2-24.8%. This state of affairs is largely due to the scarcity of extensive screening, which allows to reveal the disease at an early stage and to remove mild glandular polyps that are a precursor to cancer. Meanwhile, in Poland at the time of diagnosis in more than 50% of patients, the cancer is at an advanced stage. At this stage, the chances of healing are rapidly decreasing. At the most advanced stage (marked with the - D symbol), it amounts to approx. 5%. Therefore, extensive screening is necessary.
What are screening tests?
These are massive studies involving the study of healthy people who have no symptoms suggesting the presence of cancer, for which they want to be examined just in case. In the case of colorectal cancer, the standard premise for carrying out the research is belonging to one of the above-mentioned groups of higher risk, eg exceeding 50 years of age.
How is the issue of screening in Poland presented today?
Recently, ie from the end of 2000 in our country - at the initiative of the Ministry of Health and the Oncology Center in Warsaw - a mass screening program was launched, in which colonoscopy is used as a method of "screening" - ie revealing people at risk of colorectal cancer. Referral to the colonoscopy is obtained from the primary care physician. Being in the risk group - you can also apply yourself to the nearest oncological center with this technique.
Members:
Deaths from colorectal cancer do not show a downward trend in Poland. This is mainly due to the fact that the percentage of people who survived colon cancer surgery more than 5 years depends on the stage of cancer at the time of starting treatment. In Poland, in 50% of patients, this cancer is detected in a high degree of advancement. As a result, the percentage of people who survive for more than 5 years is only in the range of 21.2-24.8%, while for example in the Netherlands it is over 60%. This state of affairs results from the lack of extensive screening.
