Florence Cunzolo
03/31/2021 6:01 AM
Clarín.com
Good Life
Updated 03/31/2021 6:01 AM
Colon cancer is highly preventable.
The reason?
In the vast majority of cases, it is preceded by precursor lesions that, detected and treated in time,
do not become tumors
.
Despite this, in Argentina it is the second most frequent: in 2020 almost 16 thousand new cases were diagnosed and it causes
more than 7 thousand deaths annually
.
Much of the problem is explained by the fact that the number of people who undergo tracing studies is still very low, a figure that the pandemic contributed to bring down even more.
Only
one in three seniors between the ages of 50 and 75
claimed to have ever had a colon cancer screening test, such as the fecal occult blood test, colonoscopy or colon radiography by enema, according to the latest National Survey. of Risk Factors, whose data were released in 2019. This percentage (31.6%) represented a significant increase compared to that registered in the previous edition (24.5%), but it was still
very insufficient
.
And that the new coronavirus had not yet entered the scene.
The restrictions and fear imposed by the pandemic undermined all routine health checks, including those that help detect and prevent colon cancer early.
“Routine studies fell.
In September of last year it was calculated that they had fallen to 40% compared to the previous year.
We began to reverse that number, but not completely, "said Edgardo Smecuol, former president of the Argentine Society of Gastroenterology (SAGE) and doctor at Hospital Udaondo.
Meanwhile, a survey by the Argentine Society of Coloproctology (SACP) showed that consultations and surgeries for colorectal cancer (CRC) fell between
50% and 72% between March and August 2020
, compared to the same period in 2019.
In May 2020, in full quarantine, the National Program for the Prevention of Colorectal Cancer (PNPCC), which depends on the National Cancer Institute (INC), suggested temporarily suspending screening studies in the general population and focusing attention on people with symptoms digestive or with diagnosis, given the exceptional situation opened by the health crisis.
Although that recommendation was no longer in force,
the controls were not regularized
.
Impact on incidence and mortality
"There is some data from outside that shows that the drop in the realization of prevention studies will have an impact next year and the next on the incidence and mortality from colon cancer. In the United States they estimate that there will be
an increase of 10% of the incidence
(new cases per year) ", Lisandro Pereyra, gastroenterologist of the German Hospital, member of Digestive Endoscopists of Buenos Aires (ENDIBA) told Clarín.
Other data: the admissions to Captyva, the application that they created together with the doctor Leandro Steimberg and the support of the National Cancer Institute, which assists the medical community in the detection and surveillance of CRC, registered a
drop of more than 60%
in the first months of quarantine.
"It is very clear that studies were stopped. What the companies are working on is the way to reactivate them, obviously with prudence, but
we must manage that debt,
" he said.
Preventable and curable
In this sense, within the framework of the World Day for the prevention of colorectal cancer, the INC and scientific societies (ENDIBA, SAGE, AAOC, FAGE, FAAED, SACP, AAC) launched a joint campaign to sensitize the population about the importance of adopt habits that favor prevention and carry out periodic examinations for an early approach.
"Colorectal cancer (CRC) is a malignant tumor that develops in the last portion of the digestive tract: the large intestine. It occurs as a consequence of a
complex interaction of hereditary factors
and other so-called environmental
factors
that are related to
diet and style. life
. in over 90% of cases, cancer originates from a precursor lesion, called adenomatous polyps. These polyps, which are formed by the abnormal growth of cells of the colon, may develop slowly
over 10 years
", explain the organizers of the campaign.
"Colon cancer is a real health problem. In our country, it is the
second leading cause of cancer mortality
. However, it is one of the cancers that we can prevent and cure. Most colorectal cancer comes from a polyp that , if it is resected in time, it will make the transformation into cancer over the years not be achieved ", adds Raúl Matanó, head of the Gastroenterology and Digestive Endoscopy Service at Hospital El Cruce de Florencio Varela and former coordinator of the PNPCC.
Tackled early, colon cancer can be
prevented and cured in more than 90% of cases
, they say.
Who should carry out checks
Between
50 and 75 years of age
, the PNPCC established the immunochemical test for occult blood in fecal material
once a year
as the most appropriate strategy
.
In the event that this test is positive, the person must undergo a complementary colonoscopy, an examination that allows finding and removing polyps or detecting cancer (it is performed with anesthetic sedation and does not cause pain or discomfort).
Several countries have already lowered the age of initiation
of controls in the general population to 45 years.
In Argentina, there is at least one work underway to investigate whether it is justified to adopt this indication, Matanó told
Clarín
.
But there is a group of people who
must start the controls first
.
They are those who have a history of colon cancer or polyps among their direct relatives (father, mother, brother / sister, son / daughter).
In those cases, it is advised that they begin monitoring 10 years before the age at which the family member received the diagnosis.
People with inflammatory bowel disease or inherited syndromes, such as Lynch syndrome, should also start screening earlier.
"We understand the fear of contagion by the coronavirus, but all those who present some risk factor to develop the disease, should carry out the
controls according to what their treating doctor suggests,
" said Karina Collia, proctologist surgeon and member of the Service of Coloproctology of the Hospital de Gastroenterología 'Dr. Carlos B. Udaondo.
The colonoscopy is done with sedation.
Photo Shutterstock.
With symptoms, don't wait
In the early stages,
polyps do not usually cause symptoms
, which is why the general population is advised to carry out screening studies from the age of 50, when the disease increases in frequency.
However, regardless of age, everyone who detects
warning signs
should be consulted
, including anal bleeding during bowel movements and change in normal bowel movements, abdominal or rectal pain, weight loss, or anemia. .
Primary prevention
Knowing the family risk and doing screening tests are part of what is called secondary prevention of CRC.
In three out of four cases there is no family history
of the disease.
And this is where lifestyle-related primary prevention plays a key role.
The protective habits that reduce the risk are: maintaining a healthy diet, rich in fruits and vegetables, avoiding red meat and fat, exercising regularly, and reducing alcohol intake and tobacco consumption.
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