the second type of cancer is more frequent and lethal. 90% of cases arise from lesions identified with the test for the detection of occult blood in the stool
March is the month dedicated, worldwide, to the awareness of colon cancer which, with over 43,700 new cases registered every year, the second most frequent type of cancer in our country and also the second in the little sought-after ranking of the most lethal, cause of approx 19 thousand deaths a year. And the cases are on the rise – he points out Elisabetta Buscarinispokesman for the Italian Federation of Societies of Digestive System Diseases (Fismad) -, both because of the delays in screening caused by the Covid pandemic, and for the spread of incorrect lifestyleswhich are among the main causes of this neoplasm.
The delays cause Covid
Experts have already raised the alarm on several occasions. On one side, suspension of screening services (in the months of March and April 2020 in a non-homogeneous way throughout the national territory) and the delays caused by the virus on the entire health system. Thus, at the end of May 2021 (end of the third wave) the National Screening Observatory notes that from January 1, 2020 to May 31, 2021, tests for the detection of occult blood in faeces have been registered in our country a decrease of 1,200,000 units compared to 2019 (- 34% on average, but with peaks of -64% in Lombardy or -66% in Piedmont, up to -82% in the Aosta Valley), with an average delay of 5.8 months in screening programs, but with 9 Regions that are over 6 months late (such as Campania with 13 months and Lombardy with 11 months). And again: it is calculated that in that period 1,376 cancers and 7,763 advanced adenomas were lost at screening diagnosisi.e. polyps in an advanced stage of transformation towards cancer that could be eliminated in time.
Who risks more
On the other hand, especially in the United States, colon cancer has been growing for years, particularly in children between 20 and 34 years (estimates even predict a doubling of cases by 2030), while thanks to screening it decreases in the over 50s. Overweight, obesity, poor diet and a sedentary lifestyle are the main culprits. In particular dietary factors such as the consumption of red meats and sausagesrefined flours and sugars and the consumption of salty, preserved or smoked foods increase the risk of getting sick, such as excessive consumption of alcoholic beverages and smoking. About a third of colorectal cancers, then, have characteristics of familiarity ascribable to hereditary genetic mutations and specific checks are recommended for these people.
Symptoms
Making prevention even more important when you consider that this tumor often does not manifest particular symptoms, at least in its early stages – says Buscarini, director of Gastroenterology and digestive endoscopy at the Ospedale Maggiore in Crema -. The main alarm bells that must be reported to the doctor, especially after the age of 50, are: presence of bright red blood, sometimes mixed with mucus, in the stool, sense of incomplete evacuation, defecation in several short times, weight loss without obvious cause, feeling of exhaustion, low-grade fever, especially in the evening hours. Yet nine out of ten cases could be avoided because there is an effective, free (in Italy) and completely painless method to eliminate pre-cancerous lesions before they turn into a real neoplasm: the test for the detection of occult blood in the faeces.
90% of cases could be avoided
Almost 90% of colorectal cancers develop from adenomas that take years, on average about ten, to transform into malignant forms – concludes Buscarini -. in this time window that screening with the test for the detection of occult blood in the faeces allows to make an early diagnosis and eliminate intestinal polyps before they have acquired dangerous characteristics and evolve into a malignant tumor. But over half of the Italians do not take the opportunity. The exam is offered by the National Health Service to all citizens between 50 and 70 who receive, every two years, a letter from their ASL. with an invitation to go to the nearest pharmacy to collect a small container in which to collect a stool sample, to then return it and receive the letter with the report at home within a couple of weeks. In the event that traces of blood are found, further investigations must be made with colonoscopy.
March 2, 2022 (change March 4, 2022 | 14:32)
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