“Colorectal cancer is the most common digestive tract cancer, the second largest killer in Europe. However, in 2020, compared to the previous year, due to Covid in our country there was a drop in screening (-45%) and of the Italians who accepted the invitations (-20%). This inevitably meant a loss of diagnosis of tumors (-40%) and advanced adenomas (-43%), despite the fact that in Italy there are 50 thousand new cases a year and there is an Italian who dies of colorectal cancer every 25 minutes. Prevention is essential. ”He said so Elisabetta Buscarini, director of Uoc Gastroenterology and Digestive Endoscopy of the Maggiore Hospital of Crema, speaking at the round table ‘National health service and post-Covid health management’, promoted as part of the 27th National Congress of Digestive Diseases Fismad, which took place from 22 to 25 September in online mode due to the anti-pandemic rules.
A Buscarini, former president says Fismad (Italian Federation of Digestive System Diseases Society), the task of taking stock of what has been done and what should be done to promote colorectal cancer screening. “Screening – he underlined – is a great asset for the health of all citizens, not only Italians. It is a fundamental weapon, well organized and paid dearly by the Italian State. However, membership is still low: only 4 out of 10 Italians invited to undergo screening adhere to the invitation. And we do not move from this 42% membership, it was like this even before the pandemic exploded. Yet, we know well that prevention pays off: in a year, on 5% of people found positive to the test for occult blood in faeces, the advanced polyps identified with screening were 17,378 (already eliminated during colonoscopy) and 3,061 carcinomas identified. Not only that. Every year in Italy 18 thousand people among those who undergo colorectal cancer screening obtain definitive treatment with colonoscopy of advanced polyps or tumors. Furthermore, thanks to prevention and organized screening, we have a reduction in the incidence of cancer co lorectal (-20%) and specific mortality (-30%).
In his report, Buscarini highlighted that at the end of December 2020 the months of delay in prevention reached an average of 5.5 across the country. “But we know well – the gastroenterologist specified – that we have reached peaks of 9 months late in Lombardy, the region folded by the pandemic. Due to the third wave that continued to hit in the first months of 2021, we are probably to months of delay in excess of these figures. If the delay is more than 6-12 months, we will have + 3% of diagnosed more advanced cancers and + 12% of mortality from colorectal cancer. For this reason we must adopt solutions in a timely manner : rethink the screening process, think of greater communication with Italian citizens, use more resources in endoscopic technology. But we also need to invest in appropriate digital resources, human resources (gastroenterologist specialists), in addition to removing unnecessary exams from our waiting lists because they are inappropriate and take away from screening exams “.
Finally, Buscarini recalled the absolute commitment of Fismad and of the Italian gastroenterologists who in recent years have supported screening for colorectal cancer at all levels, “including that of speaking directly to Italians. We did it with a campaign carried out on all channels, starting from the concept that prevention cannot be based on luck. We have chosen a definitely aggressive message, associated with the face of a much loved actor, to try to enter the homes of Italians and explain to them how important and precious this path is that the Italian State has widely supported and implemented for a long time “.