Expert advises early colon cancer screening to save lives

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A Filipino doctor is strongly advocating early colon cancer screening to prevent and cure the fourth most common cancer in the country.

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Dr. Jun Ruiz of St. Luke’s Medical Center in Bonifacio Global City on Friday said March is celebrated as Colorectal (or simply Colon) Cancer Awareness Month, a campaign first launched in 1999 by the Center for Disease Control and Prevention to aggressively promote screening.

Ruiz added that this campaign increased the colon cancer screening rate among Americans from 50 percent in 2002 to 65 percent in 2012. Sadly, in the Philippines, awareness of colon cancer has not been as extensive as that of lung and breast cancer, although the disease killed former President Corazon Aquino. Filipinos must be made aware of colon cancer screening to save lives, he stressed.

Colorectal cancer (involving either the colon or rectum) is the third most common cancer in the world (only lung and breast cancer affect more individuals), and the second most common cancer killer affecting both men and women. In the United States, six out of 100 people develop colorectal cancer in their lifetime. In the Philippines, the Philippine Cancer Society reported that colorectal cancer is the fourth most common cancer after breast, lung and liver cancer.

Ruiz said colorectal cancer screening has been shown to reduce colon cancer risk by as high as 60-70 percent. The cancer usually starts as abnormal growths in the colorectal mucosal lining called adenomatous polyps. Screening tests are available to visualize polyps, so they can be removed before they turn into cancer, or detect early cancer so cure can be achieved. The five year-survival rate of persons affected with this cancer is 90 percent when it is diagnosed early, but less than 10 percent when diagnosed in an advanced stage.

He revealed that a review of medical literature showed a strong association between colon cancer and a diet that has high fat (usually saturated fat), low fiber and high red meat. This type of cancer is also associated with cigarette smoking, lack of physical activity, alcohol intake and obesity. Thus, fiber that regulates bowel movements and dilutes carcinogens should be part of every meal. Also, limited data suggest foods rich in carotene (vitamin A) and vitamin C can act as anti-oxidants in the chemoprevention of colon cancer.

Ruiz explained that risk factors that predispose an individual to develop colorectal cancer include age, a personal history of adenoma or carcinoma, a family history of colorectal cancer and pre-existing diseases, like inflammatory bowel disease. Ninety percent of cancers occur after the age of 50, he said. A personal history of colorectal adenomas or prior cancer is another major risk factor. The risk of an individual with a first-degree relative with sporadic cancer is increased two- to three-fold. The risk is higher when the cancer occurs before the age of 60, or when two relatives have cancer.

Ruiz said afflicted persons may complain of rectal bleeding and anemia, leading to fatigue, shortness of breath and weight loss. Abdominal pain, changes in bowel habits/stool caliber and constipation are found in advanced cases.

Thus, when colon cancer is suspected, prompt endoscopic examination of the colon should be performed, he advised. Colonoscopy is the procedure of choice in which a flexible instrument with a camera is inserted through the anus and rectum and is carefully advanced to visualize the entire length of the colon under mild anesthesia.

Ruiz said early and localized lesions are curable by surgical resection. He assured the public that the methods of screening (fecal occult blood test, sigmoidoscopy and colonoscopy) have been proved to be cost-effective. He counseled that screening should be accompanied by programs to educate patients and heighten physician awareness of the concepts and logistics involved in cancer screening, diagnosis, treatment and follow-up.

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