Colorectal cancer: the importance of screening

The colorectal cancer is the second most common cancer in Italy, with about 51,000 cases a year (13% of all cancers), with a ratio that the country has gradually reduced thanks to the introduction of screening. But there is a positive message: despite this incidence, we are witnessing a progressive decrease in mortality. Two out of three patients recover.

Is this tumor born malignant or following an evolution?

In most cases the neoplasm is preceded by the onset of a benign polyp , which takes years to become a malignant neoplasm. This means that we have time to diagnose and cure it.

How do you recognize it?

The initial symptoms of colon rectal cancer can be nonspecific: the presence of blood at the time of defecation is very frequent. In addition to the visit, colonoscopy is essential for diagnosis, which can identify the tumor or the presence of polyps, which are frequently the precursors of the cancer itself.

What to do if a polyp is diagnosed?

If a polyp is detected during colonoscopy , it is generally possible to remove it directly in endoscopy during the session itself.

What if a tumor is detected instead?

In this case the process is different and requires a multidisciplinary framework which can vary according to the case. Surgery in the first instance is not always the most suitable treatment: the patient could in fact obtain benefits from radio or chemotherapy before the operation.

To date, how are the surgeries to remove colorectal cancer?

They are less and less invasive. Resective bowel surgery can be performed by laparoscopy , i.e. by making only small incisions. The percentage of permanent ostomies has fortunately decreased, also thanks to the association of surgical treatments with other therapies, as explained above.

In case of metastasis what hopes are there?

Therapies have evolved in recent years, making targeted drugs available for use following examinations and interventions. Even in case of metastasis it is possible to implement a multidisciplinary evaluation and treatment on several fronts, thus arriving at results unthinkable until a few years ago.

Is screening an ally for diagnosing this neoplasm?

Of course! The screening programs for this type of cancer are active on the Italian territory for people aged between 50 and 70 and should be performed every 2 years. It is an exam that looks for occult blood in the stool. Let’s dispel the belief that screening doesn’t work: modern immuno-chemical tests have both good sensitivity and good specificity. If the test is positive, a colonoscopy should be done.

Colon cancer and diet: is there a relationship?

Certainly yes, with the exception of genetic forms: a diet mainly based on red meats, sausages, flour and refined sugars, as well as being overweight, the habit of smoking and alcohol intake are all factors that favor the onset of this neoplasm. On the contrary, a diet that favors the intake of fiber, fruit, vegetables and unrefined carbohydrates certainly reduces the risk of development.


by Abdullah Sam
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