Prevention and early screening of gastrointestinal cancer

Among the new cancer cases in my country in 2020, colorectal cancer (560,000 new cases) ranked second, and gastric cancer (480,000 new cases) ranked third. The incidence of gastrointestinal cancer in my country ranks fourth and fifth among malignant tumors, and its mortality rate ranks third and fourth among malignant tumors, respectively. The early diagnosis rate is only 10-30%, and 70-90% of patients are in the advanced stage. Therefore, reasonable prevention and timely and accurate early diagnosis are essential for the treatment and prognosis of gastrointestinal cancer patients.

1. What can we do to prevent gastrointestinal cancer?

①. Beware of family history

This disease has a certain degree of family clustering. Family members with relatives suffering from gastrointestinal cancer should take the initiative to undergo regular gastrointestinal endoscopy even if they do not have any discomfort symptoms.

② Improve your diet

High-risk factors for gastric cancer include: high-sugar and low-protein foods, high-salt diets, moldy foods, and nitroso compounds from bad eating habits, which are all high-risk factors for gastric cancer; and high-fat, high-calorie, low-fiber diets and diets containing sulfur microorganisms are all likely to become risk factors for intestinal cancer. This is what people often call a high-fat, high-calorie, low-fiber diet and a diet containing sulfur microorganisms. Therefore, prevention through dietary intervention, increasing the intake of fresh fruits and vegetables, and limiting the consumption of salt and salted foods may have a certain protective effect, which can delay the development of colorectal cancer and inhibit the occurrence of colorectal cancer.

③. Change your lifestyle

Lifestyle changes, including increasing physical activity, controlling weight, limiting smoking and drinking, can also reduce the risk of disease. Mental depression will inhibit the parasympathetic nerves, reduce the release of acetylcholine, and reduce the body's immunity, so keeping a happy mood is also essential.

④. Eradication of Helicobacter pylori

The imbalance of cell proliferation and apoptosis caused by Helicobacter pylori infection, gastric cancer-related gene mutations, acute and chronic inflammatory reactions of the gastric mucosa, etc. can all promote the occurrence and development of gastric cancer. Therefore, eradication of Helicobacter pylori infection is essential.

⑤. Pay attention to the precancerous lesions of gastric cancer

The occurrence of gastric cancer is a process of normal gastric mucosa - chronic non-atrophic gastric mucosa - chronic atrophic gastric mucosa - intestinal metaplasia - low-grade changes of intradermal neoplasia - high-grade changes of intradermal neoplasia - gastric cancer.

⑥ Pay attention to the balance of intestinal microecology

As the research on intestinal microecology gradually deepens, the intestinal flora, which has a complex symbiotic relationship with the host, maintains the stability of the intestinal environment and protects the intestine from inflammation and cancer. Under healthy conditions, they maintain a significant relationship with the host. Microecological imbalance can directly affect the mechanism that causes colorectal cancer, such as exposure to antibiotics, stress, and certain dietary ingredients.

2. How to detect gastrointestinal tumors as early as possible

① Blood test

The most common peripheral blood markers for digestive tract tumors include carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), carbohydrate antigen 724 (CA724), gastrin, pepsin, etc. However, the simple determination of peripheral blood tumor markers is not enough for screening.

②, fecal occult blood test

Fecal occult blood test can indicate whether there is gastrointestinal bleeding. Gastrointestinal bleeding greater than 5ml may be positive for fecal occult blood. The advantage of this test is high sensitivity, but it is not very specific and the bleeding site is unclear. In addition, hemorrhoids and perianal lesions, and the intake of large amounts of meat and animal offal may also cause positive fecal occult blood.

③ Imaging examination

Imaging examinations mainly include abdominal ultrasound, CT colonography, tuberculosis magnetic resonance imaging, PET-CT, etc. Because early gastrointestinal cancer lesions are small, it is difficult to detect them through imaging examinations. In addition, the quality of the examination is greatly affected by gastrointestinal motility, so the stomach cavity needs to be fully dilated and the intestines prepared before the examination. However, imaging examinations are helpful in determining the size of the tumor, the degree of infiltration, the presence of lymph nodes, and the presence of distant metastasis.

④ Gastrointestinal endoscopy

Gastroscopy is mainly used to check the lesions of the esophagus, stomach, duodenal bulb, and descending duodenum, such as whether there are inflammation, ulcers, erosions, tumors, etc. At the same time, biopsies can be taken from the lesions under gastroscopy and sent to pathological examination to understand the nature of the lesions. The main parts observed by colonoscopy are the rectum, sigmoid colon, descending colon, transverse colon, ascending colon, ileocecal part, terminal ileum, etc., and the congestion of the mucosa in the above parts can be understood like gastroscopy, whether there is edema, inflammation, erosion, ulcers, masses, polyps, etc. Gastroenteroscopy can assist in diagnosis, treatment, efficacy evaluation and follow-up after treatment, etc.

⑤. Pay attention to the precancerous lesions of gastric cancer

Gastric cancer is a process of normal gastric mucosa - chronic non-atrophic gastric mucosa - chronic atrophic gastric mucosa - intestinal metaplasia - intraepithelial neoplasia at a low level - intraepithelial neoplasia at a high level - gastric cancer. If atrophy, intestinal metaplasia, and mild or severe intraepithelial neoplasia are found in gastroscopy and pathological biopsy, you need to seek medical attention in time and follow up regularly according to the doctor's advice.

Author: Fu Danqing, Bazhong Central Hospital