Noin the wastebasket, in the drawer, in the paper collection. This is where many of the letters that arrive after the age of 50 from the local health authorities end up, inviting you to take the test for the prevention of colorectal cancer. Why? Out of fear, because there’s still time, why should it be me? We have forwarded these questions to those who fight against this neoplasm every day and who, if all those letters were opened, would have much, much less work.
There are various levels of prevention
Not just for the colon. «Prevention is essential for all types of cancer, well the 50% of them are avoidable if only first level prevention is carried out» explains la Professor Erika Martinelli, associate in Medical Oncology at the University of Campania Luigi Vanvitelli in Naples. «With the first level prevention we act on nutrition and lifestyle. In particular, it is important for the colon to fight obesity, maintaining an adequate weight from an early age, constantly exercising and eating healthily according to the 5 a day rule» clarifies the expert.
For a colon-saving diet
It’s not yet another starving diet. The 5 a day rule is even recommended by WHO, the World Health Organization, as a good rule of thumb to protect the colon and intestines from cancer. And not only. It consists of eating throughout the day 5 meals containing fruit (150 grams) and vegetables (100 grams). In practice, to stock up on fibres, which are the sweepers of the intestine, it would be ideal to consume fruit at every snack and vegetables, cooked or raw, for lunch and dinner.
Green leafy vegetables help cleanse the intestines of “waste” that can favor colon cancer, but apples and carrots are also very useful. (Getty Images)
It is secondary prevention that is ignored
As long as it comes to eating healthily, let’s say that many at least try. Or at least progress has been made in recent years, even if obesity is a problem that is far from solved. And it negatively affects the appearance of the tumor. Secondary prevention, on the other hand, involves a little effort on our part and this is where the letter from the ASL comes into play. «From the age of 50 onwards one is invited to do fecal occult blood test» explains Professor Martinelli. «It is a free test to be done at home, which consists in swiping a stick, included in the kit, on your own feces. Then you send the sample to the laboratory for analysis and the result arrives in a few days. A small gesture that can save lives, however,” concludes the oncologist.
Why so much reluctance to take this exam?
There is no pain, it is not invasive, so where is the problem in following this prevention which is also free, both for women and men over 50? “Perhaps it is not clear that colorectal cancer is one of the most frequent and also the most dangerous, if it is not discovered at an early stage» explains the oncologist. According to the data Aiom As of 2022, colorectal cancers are the third most diagnosed cancer in men and the second most diagnosed in women. In Italy, compared to 2020, there has been an increase +1.5% and +1.6% respectively3.
The sooner you find out the better
Early colon cancer has no symptoms. “If it’s in the initial stage the patient is likely to be free from the disease: in 85% of casesi 5 years after diagnosis, the disease has not recurred. This is why the occult blood test is so important,” explains the oncologist. The more the tumor advances, the more survival decreases, because the lymph nodes are also involved and then metastases occur, i.e. the tumor from the colon or rectum migrates to other organs. «Even if we cannot generalize, it can be said that, from a statistical point of view, if colorectal cancer is at the third stage, the chances of healing drop to 45%. If you even get to the fourth stage with metastases and no longer operable, survival hardly exceeds 33 months from diagnosis. In short, is it worth going to pick up that letter from the trash?
When it’s just a polyp
«We oncologists really don’t want to see metastatic patients anymore, because beyond some specific hereditary cases, the most colon cancers could be prevented fecal occult blood test. This test also allows you to discover the presence of an adenomatous polyp, which may be benign at the moment but can then mutate and turn into a tumor. It can happen even after 10 years. With colonoscopy, if the polyp is small, it is removed. Of course under sedation, without major discomfort for the patient, if not the hassle of preparing for colonoscopy or rectoscopy.
The general practitioner should be the first to invite people to join colon cancer screenings. And not only. (Getty Images)
To assess your level of risk
It is possible to do an online test that allows you to understand if in the face of some signs it is better to go immediately to a specialist. The questionnaire, “Symptom Checker CRC” created by the pharmaceutical company Merckdoes not want to replace the doctor, but wants bring people closer to preventionoffering a simple guide to what may be the most common symptoms of colon and rectal cancer.
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