National Cancer Prevention and Treatment Publicity Week | Li Yanqing: Pay attention to colorectal cancer prevention and control to achieve early screening, early diagnosis and early treatment

Editor's Note: April 15-21, 2024 is the 30th National Cancer Prevention and Control Publicity Week. This year's theme is "Comprehensive Measures for Scientific Cancer Prevention". In accordance with the relevant requirements of the "Healthy China Action-Cancer Prevention and Control Action Implementation Plan (2023-2030)", in order to further expand the popularization of cancer prevention and control science, this magazine has specially launched a manuscript solicitation and essay solicitation activity on the occasion of the National Cancer Prevention and Control Publicity Week, and selected excellent articles for readers. In recent years, colorectal cancer has become one of the malignant tumors with the fastest increasing incidence and mortality in China. The latest data from the National Cancer Center in 2022 showed that colorectal cancer has jumped to the second place in the incidence of malignant tumors in men, and ranked fourth in women, with a high mortality rate. It is estimated that by 2030, the number of new cases and deaths of colorectal cancer in the world will reach 2.45 million and 1.22 million respectively, and the number of new cases and deaths of colorectal cancer in China will account for 30% of the world. In the face of such a severe situation, it is crucial to raise public awareness of colorectal cancer and popularize prevention and screening knowledge.

Li Yanqing

Causes of colorectal cancer

The incidence of colorectal cancer is related to many factors, including uncontrollable factors such as genetics and inflammatory bowel disease, but it is more closely related to an unhealthy lifestyle. Sitting for long periods of time, obesity, high-fat diet, smoking and drinking will increase the risk of colorectal cancer. On the contrary, more exercise, more intake of fruits and vegetables, whole grains and high-fiber foods, and controlling the intake of red meat and processed meat products can help prevent colorectal cancer. Starting from daily life, moving the prevention and treatment threshold forward, paying attention to the primary prevention of colorectal cancer, and cultivating healthy living habits can lay a good foundation for the prevention of colorectal cancer.

Timely screening and early diagnosis and treatment are crucial

Early colorectal cancer often has no obvious symptoms. It usually takes 5 to 10 years or even longer for precancerous lesions to gradually develop. This period is clinically called the "screening window" for colorectal cancer. Screening and detecting lesions and then removing precancerous lesions in a timely manner can effectively block the process of canceration and prevent the occurrence of colorectal cancer. It is an effective supplement to the primary prevention of colorectal cancer. Early screening, early diagnosis and early treatment can make the 5-year survival rate as high as 90%. Once this period is missed, when the tumor invades the intestinal wall or even metastasizes to distant sites, complex treatments such as surgery, radiotherapy and chemotherapy are required, and the efficacy and prognosis are greatly reduced. Therefore, even if there is no discomfort, we must be vigilant, undergo regular screening, and grasp the key period of prevention and control. For high-risk groups such as those with a family history of colorectal cancer and a history of ulcerative colitis, they must strictly abide by the screening schedule, participate in screening regularly and in a timely manner, and do not miss the opportunity for prevention and control.

It is generally recommended that people over 50 years old undergo regular screening. If there are high-risk factors such as a family history of colorectal cancer, screening should be carried out in advance and at a higher frequency. Currently, the most commonly used screening methods in clinical practice are fecal occult blood test and colonoscopy. White light colonoscopy is the basis for diagnosing colorectal cancer lesions. With the development of innovative endoscopic technology, image-enhanced endoscopy has been widely used. A large amount of evidence-based medical evidence shows that linked imaging endoscopy (LCI) and other technologies can significantly improve the efficiency of colonoscopy screening and detect more colorectal adenomas. Timely treatment can effectively prevent the occurrence of colorectal cancer. The implementation of a sequential examination mode with white light endoscopy for insertion and image-enhanced endoscopy represented by LCI for withdrawal can effectively ensure the quality of colonoscopy and improve the detection rate of colorectal tumors. High-sensitivity quantitative fecal immunochemical test (hs[1]qFIT) is low-cost and easy to operate. It has good detection sensitivity and specificity for colorectal adenomas and is more suitable for screening in the Chinese population. Carrying out popular science publicity on colorectal cancer, improving people's awareness of the disease, and promoting screening methods represented by hs-qFIT will help reduce the burden of colorectal cancer-related diseases in my country.

Treatment of colorectal cancer

Currently, for patients with confirmed colorectal cancer, standardized comprehensive treatment can also significantly improve the prognosis, survival rate and quality of life. According to the stage and pathological type, endoscopic surgery or surgical surgery is often used in clinical practice, supplemented by radiotherapy, chemotherapy, targeted therapy, immunotherapy and other multidisciplinary comprehensive treatment models. In recent years, super minimally invasive and surgical techniques and comprehensive treatment plans have been continuously optimized, which has benefited patients a lot.

In short, the trend of increasing incidence and mortality of colorectal cancer in my country continues, and the prevention and control situation is not optimistic. However, the incidence and mortality of colorectal cancer can be reduced by changing bad living habits, improving disease awareness, undergoing regular screening, early diagnosis and treatment, and actively cooperating with standardized treatment after diagnosis.

(Author: Li Yanqing, Department of Gastroenterology, Qilu Hospital, Shandong University)