Prevention of colorectal cancer: early screening, early intervention and early benefit

"Prevention and control of chronic diseases cannot be slow, so we must catch them early. Cancer prevention, early screening first. " Recently, Wu Jing, director of the Institute of Chronic Diseases of China CDC, said at the kick-off meeting of the first China Cancer Early Screening Day.

The National Cancer Report 20 19 issued by the National Cancer Center shows that in 20 15 years, there were about 3.929 million new cases of malignant tumors in China, with an average of 7.5 cases of cancer diagnosed every minute. The death toll is about 2.338 million, with an average of 4.5 people dying of cancer every minute.

"Lung cancer, gastric cancer, colorectal cancer and liver cancer are still the main malignant tumors in China. These cancers also have the same feature. Most of them were discovered in the middle and late stages. The cost of advanced cancer treatment is higher and the five-year survival rate is lower. " Jason Wu said.

"The most important way to prevent intestinal cancer is to find intestinal polyps in the early screening process, so that patients can remove the lesions through minimally invasive surgery 5- 10 years before the deterioration of intestinal cancer." Wang Xishan, Chairman of the Colorectal Cancer Professional Committee of China Anti-Cancer Association and Director of Colorectal Surgery of Cancer Hospital of China Academy of Medical Sciences, stressed.

Wang Guiqi, director of the Department of Endoscopy, Cancer Hospital of China Academy of Medical Sciences, said that colorectal cancer has three characteristics: the early symptoms are not obvious, the intervention window is long, and early intervention is conducive to survival. Early colorectal cancer usually lacks specific symptoms. With the progress of the disease, there will be symptoms of intestinal obstruction such as abdominal distension, abdominal pain and even bloody stool. At the same time, the occurrence and development of colorectal cancer takes a long time, from proliferative lesions to adenoma, canceration, clinical cancer to advanced tumor, which takes about 5- 10 years, and there are enough opportunities for screening and prevention. The survival rate of colorectal cancer can reach more than 90% if it is intervened early.

Chen Wanqing, director of the Cancer Early Diagnosis and Treatment Office of the National Cancer Center, said that people can be stratified first, and screening methods suitable for them can be adopted to guide people to seek medical treatment accurately, so that colonoscopy can become the last barrier for screening colorectal cancer.

In Chen Wanqing's view, we must first understand the risk factors of colorectal cancer, and conduct colorectal cancer risk assessment from the age of 40, and make clear the risk level. If you are a high-risk group, it is recommended to participate in colon cancer screening regularly. According to the situation, screening methods such as colonoscopy, fecal occult blood detection, intestinal CT colon imaging, and multi-target fecal FIT-DNA can be selected. If there are related genetic diseases, the start time of screening should be further advanced.

The multi-target fecal FIT-DNA combined detection technology independently developed in China has also been recommended by the Guidelines for Early Diagnosis and Treatment of Colorectal Cancer Screening in China (2020), and it is clear that the non-invasive multi-target fecal FIT-DNA combined detection technology is one of the important means for early screening of colorectal cancer. This technology has been verified by large-scale prospective multi-center registered clinical trials and approved by the State Administration of Pharmaceutical Products. Suitable for screening high-risk population of colorectal cancer aged 40-74.

"Overcoming cancer is a systematic project. Cancer control should be strengthened from three strategic levels. " Wang Xishan said. At the national level, it is necessary to "move forward and focus on prevention"; On the social level, it is necessary to realize "homogenization of specialties and standardization of patient treatment"; At the personal level, improve everyone's awareness of cancer prevention and change bad lifestyles and eating habits. Only by connecting the three levels into a whole can we reduce the incidence, improve the survival rate, reduce the mortality rate and benefit more patients.

(People's Daily Central Kitchen Health 37 Studio Wang Junping)