Colorectal Cancer: Don't Wait for Symptoms to Appear Before Taking Action

Many people come to the hospital at a late stage.

Sharing at the seminar "Screening, diagnosis and treatment strategy for colorectal cancer in Vietnam" organized by Nhan Dan Newspaper in collaboration with Phacogen Institute of Technology on the morning of May 11, Associate Professor, Dr. Pham Cam Phuong said that colorectal cancer often starts from very small lesions, such as polyps. Early detection, right from the polyp stage or early stage cancer, can increase the survival rate up to 93%. Early screening will help determine the patient's risk, thereby helping to diagnose early, accurately and promptly.

However, the biggest obstacle to early detection of colorectal cancer in our country is the limited awareness of the community. Many patients come to the clinic when the disease has progressed, because they do not have the habit of regular screening or are concerned about the cost, or are afraid of having to undergo endoscopy, anesthesia, etc.

"The worrying thing is that when patients come for examination, it is often in the late stages. We find cancer cells that have invaded deep into the intestinal wall, spread to the lymph nodes, and even metastasized to the liver or lungs. At this point, the chance of successful treatment is greatly reduced," Dr. Phuong shared.

Associate Professor, Dr. Vu Van Khiem, General Secretary of the Vietnam Gastroenterology Association, said that most colorectal cancer lesions develop silently and without symptoms in the early stages. When patients begin to feel abdominal pain, digestive disorders or bloody stools, they are usually in an advanced stage.

Associate Professor, Dr. Vu Van Khiem, General Secretary of the Vietnam Digestive Science Association. (Photo: THANH DAT)

According to Dr. Khiem, currently, in the world, there are popular colorectal cancer screening methods such as: Colonoscopy (standard method, highly accurate); fecal occult blood test (not optimal accuracy); virtual colonoscopy (using CT scan to create 3D images of the colon, but still need colonoscopy if there is suspicion); multi-target DNA test in stool.

According to GLOBOCAN statistics in 2022, our country recorded more than 16,000 new cases and over 8,400 deaths from this disease - ranking 4th in incidence and 5th in mortality among cancers.

This expert believes that if people are still afraid of invasive screening measures such as endoscopy, then fecal occult blood testing is an optimal method that is being used in some countries around the world.

With this method, molecular markers appear very early in the body, from the stage of precancerous lesions. Every day, the body excretes a lot of colon and rectal epithelial cells through stool. Therefore, if there are abnormal signals in the colon or rectum, the patient can perform a screening test to detect colorectal cancer early from stool samples.

"Currently, the US and China are the two major countries applying multi-target DNA testing in stool, showing sensitivity and specificity of over 90%. The US also recommends that people should do this test every 1-3 years. Therefore, one of the best methods for screening for colorectal cancer is community stool testing. When a positive result is detected, we will recommend that patients undergo colonoscopy to detect inflammation, ulcers, or lesions," Professor Khiem shared.

Doctor Phuong recommends that when people see unusual symptoms such as digestive disorders, abdominal pain, changes in stool shape, bloody stools, or always wanting to defecate... they need to go to the doctor early to detect lesions immediately through endoscopy and perform testing procedures under the intervention of endoscopy to diagnose the disease.

Associate Professor, Dr. Pham Cam Phuong. (Photo: THANH DAT)

"People should not wait for symptoms to appear before taking action. Be proactive in regular screening using modern methods such as colonoscopy or eColon, especially from the age of 45, to detect polyps or cancer early - when the cure rate can reach 90%. Prioritize proven screening methods, especially internationally standardized tests such as IVD standards," Dr. Phuong shared.

Early community screening strategy needed

Associate Professor, Dr. Nguyen Cong Hoang, Member of the 15th National Assembly, Director of Thai Nguyen Central Hospital shared that many developed countries such as the US, UK, Japan or Korea have now performed many early diagnoses in the field of cancer, thanks to which, the rate of cancer patients has decreased significantly.

He also said that currently, colorectal cancer screening programs have been widely implemented at the national level. Organizing periodic screening for adults aged 45-50 and above has brought about remarkable results, with the rate of early cancer detection increasing, while the rate of new cases and deaths from colorectal cancer decreasing sharply.

"In the US, after increasing nationwide screening coverage, colorectal cancer mortality rates have fallen by more than 50% over three decades (according to the CDC). In the UK, a national screening program has helped quadruple the rate of early cancer detection, while also contributing to a significant reduction in mortality...", Associate Professor, Dr. Nguyen Cong Hoang cited.

Associate Professor, Dr. Nguyen Cong Hoang, Member of the 15th National Assembly, Director of Thai Nguyen Central Hospital shared at the seminar. (Photo: THANH DAT)

These results emphasize the essential role of screening in community-based colorectal cancer prevention and control strategies.

The Director of Thai Nguyen Central Hospital believes that the colorectal cancer screening strategy in Vietnam should be oriented towards three pillars: First, strengthen communication and health education, helping the community understand that they should be screened from the age of 45 as recommended. At the same time, review their personal and family medical history to self-assess their colorectal cancer risk and see medical staff when necessary.

Second, integrate screening activities into regular health check-ups at health facilities. Finally, prioritize the application of non-invasive, easy-to-implement, and cost-effective screening methods. These are methods that can be completely integrated into large-scale community screening programs without putting pressure on the health system.

Delegates share professional knowledge at the seminar. (Photo: THANH DAT)

Associate Professor, Dr. Pham Thi Cam Phuong hopes that in the coming time, the Ministry of Health and leading experts will develop screening guidelines so that medical facilities have a set of standard guidelines, avoiding the abuse of prescribing multiple tests in cancer screening.

"I hope these screening guidelines focus on high-risk subjects and are covered by health insurance. If health insurance is included, it will help many people detect the disease at an early stage, with low treatment costs and high treatment effectiveness. Then we will see the value of early screening for the community," Dr. Phuong shared.

Source: https://nhandan.vn/ung-thu-dai-truc-trang-dung-cho-doi-xuat-hien-trieu-chung-moi-hanh-dong-post879003.html