Is intestinal cancer screening?How to do it?How old do you do?See Professor Zhang Suzhan’s comprehensive answer
Now it is the National Tumor Prevention Propaganda Week. The China Cancer Foundation and the medical community jointly sponsored the “2020 Cancer Prevention and Control in Action” large -scale public welfare activities. Children, two aunts take a look at Professor Zhang’s answer!
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Q1: What is the incidence of colorectal cancer in my country? Is it true that my country is the big country of colorectal cancer on the Internet?
Professor Zhang Suzhan: my country is not only a “lung cancer country” and “gastric cancer country”, but also a “big country of colorectal cancer.” According to the 2019 National Cancer Center data, in 2015, China’s colorectal cancer was 388,000 new cases and 187,000 death cases. At present, the incidence of colorectal cancer ranks among the top three in China, and the mortality rate ranks fifth. To change the current status of high incidence of colorectal cancer and high mortality, screening is the key!
Q2: Some friends around me are not optimistic about the survival of colorectal cancer. Why?
Professor Zhang Suzhan: Early “no shadow” in colorectal cancer. Patients are mostly in the late stage when diagnosis, which makes people fear and leaves many regrets. At present, the intensity and coverage of early diagnosis and screening of high -risk people in colorectal cancer needs to be improved, and failure to detect colorectal cancer in early onset is one of the main reasons for patients to survive. If “cat -greasy” can be found in the early stage of cancer, the patient’s five -year survival rate can reach 100%, but if the cancer is discovered in the late stage, the patient’s five -year survival rate will be significantly reduced.
The development process of bowel cancer is actually very slow. About 10-15 years, there are many test windows. Most of the patients we treat the first diagnosis of the first diagnosis are already in the middle and late stages, and the best treatment time is missed.
Q3: What are the main methods of colorectal cancer screening?
Professor Zhang Suzhan: Screening can effectively reduce the incidence and mortality of bowel cancer. At present, colonoscopy is a gold standard for colorectal cancer screening. In addition, it can use stool potential blood and molecular biology detection methods.
At present, colonoscopy is the most reliable colon cancer screening method. It can not only find pre -cancer lesions and early bowel cancer, but also directly treat it. However, it is an invasive technology. Difference.
Poor stool potential blood is a relatively simple and effective screening method, and the compliance of the crowd is relatively high. In order to further improve the compliance of the screening, you can choose the optimized immune method stool potential blood technology. This technology is similar to the early pregnancy test paper, which is very convenient and innocent. The test results.
Many patients ask, what is the effect of CT simulation colonoscopy screening? It has a poor discernic ability for lesions below 1cm, expensive costs, high technical requirements and radiation, and not cost -effective.
Q4: How old is starting to screen colorectal cancer? How big is the early screening?
Professor Zhang Suzhan: “The Analects of Confucius” said: “Forty but not confused.” But when facing a tumor doctor, he will tell you that forty years old, you have to start screening colorectal cancer! High -risk population of colorectal cancer needs to increase the frequency of screening or appropriately advance the screening age.
What are the high -risk people? Points! One or more of the following 5 items is high -risk of colorectal cancer:
A. History of first -level relatives of colorectal;
B. My intestinal polyps;
C. History of cancer;
D. There are 2 or more of the following 6 items: chronic diarrhea, chronic constipation, mucus blood, chronic appendicitis, history of mental stimuli, chronic biliary disease history;
E. Immunohistan stool hidden blood test (FOBT) (+).
Q5: What is the specific path of colorectal cancer? Is it tedious?
Professor Zhang Suzhan: The screening of colorectal cancer is not as troublesome as we think. You can carry out preliminary screening, sieve, and diagnosis according to the crowd.
Generally speaking, the target group of colorectal cancer is 40-74 years old. In the preliminary screening plan, first conduct questionnaire risk assessment or feces immunochemistry test (FIT); for the high-risk/hidden blood-positive patients to implement the sieve scheme, that is, molecular detection (FIT-DNA test); Inspection of colonoscopy, positioning the lesion site and diagnosis and treatment.
Q6: What should the elderly pay attention to colorectal cancer screening?
Professor Zhang Suzhan: Age is not an absolute factor. Generally speaking, if the patient’s expected life span is less than 10 years, the screening of bowel cancer is very small. Although the tumor is prevented, it is likely to die due to heart disease, diabetes and other diseases.
If the elderly do not merge other diseases and have a long life span, the age of screening can be relaxed to 75 years old. The screening of the elderly should consider whether colonoscopy, because colonoscopy is “invasive”, which will bring pain and discomfort to patients. And patients who need to take laxatives before doing colonoscopy to discharge intestinal feces. Some elderly people may have collapse after taking laxatives.
It is recommended that the elderly should be accompanied by children when screening for colorectal cancer, and under the guidance of a doctor.
Q7: If someone in my family suffer from colorectal cancer, will my risk of onset be higher? Is it going to be screened early?
Professor Zhang Suzhan: If someone in your family suffer from colorectal cancer, then the risk of colorectal cancer will definitely increase, usually 3-4 times higher than ordinary people.
But even if the risk of onset increases by 3-4 times, you may not have bowel cancer. It is recommended that patients with colorectal cancer do the corresponding genetic measurement to understand whether they are genetically genetic. If a genetic mutation of highly geneticity, family members must regularly screen colorectal cancer, and then scientifically prevent prevention of prevention and prevention. control. Q8: What are the dilemma in my country ’s colorectal cancer screening?
Professor Zhang Suzhan: In fact, the screening of colon cancer in my country has a certain dilemma! The summary is mainly the following six points.
Large population base: census and screening costs of colorectal cancer, high screening costs, poor efficiency;
Low participation in the subject: The subject of the subject of the screen cancer is low, the enthusiasm for participating in screening is not high, and the disease prevention concept is weak;
Poor colonoscopy: Early sieve high -risk population colonoscopy is poor;
Low colonoscopy detection rate: 20%-30%colonoscopy detection rate;
The screening technology is backward: the existing screening technology is sensitive, the specificity is not high, the screening positive compliance rate is low, and the operation process is complicated;
Screening strategy is single: questionnaire+stool blood+colonoscopy strategy, which consumes huge resources and often ignores the subjective initiative of the crowd.
To solve these difficulties, the public and doctors need to work together!
Q9: Do I need to cut off intestinal polyps? Is it still possible to turn into cancer after cutting?
Professor Zhang Suzhan: There are different types of tissue polyps. If it is inflammatory polyps, the chance of cancer is less; if it is adenoma polyps, it will definitely transform to cancer.
If there is no surgical resection, the naked eye cannot accurately judge the type of polyps through the colonoscopy, so the current guidelines recommend that as long as the polyps are found, it is recommended to cut it off under the colonoscopy and do a pathological examination.
If the polyps are cut down through pathological examination, it is determined to be a high -level tumor deformation, and it will not cancer after treatment. If the polyps are canceled after cutting, the cancerous part should be consumed clean and whether it will recur.
