Colorectal cancer prevention programme

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What is bowel cancer?

It is a malignant tumor, also known as cancer or neoplasia, coming from cells in the mucous membrane of the large intestine. It almost always comes from a growth known as a polyp. It can develop locally, deeply invading the layers that form the wall of the digestive tract, and from there move into any organ, whether in the abdominal region or further away, spreading through the lymph vessels or through the blood.

Incident

It's the most common type of cancer in Spain, taking into account both men and women (it's the second most frequent among women, after breast cancer, and the third most common among men, after prostate cancer and lung cancer), with around 30,000 new cases per year. In Spain, survival after 5 years is 64%, and the European average is 57%. It is practically nonexistent before the age of 40-45, but becomes substantially more prevalent after the age of 60. If affects 1 in 20 men and 1 in 30 women before the age of 74.

Detection

Bowel cancer is one of the few types of cancer that can be diagnosed in advance, that is, before symptoms appear. In most cases, it develops from small lesions inside the large intestine (polyps), which can bleed intermittently without causing any irritation.

For this reason, it is detected via a faecal occult blood test, which can be carried out at home using a very simple kit. The test does not need to be taken on an empty stomach, nor does it require any kind of dietary change.
Analyses within health centres allow for the detection of small quantities of blood within stools, which may not be visible to the naked eye.

If no blood is detected in the test, bowel cancer is unlikely. In five of each one hundred people appear indications of blood, almost always because of a benign injury and in few cases as a result of the existence of a cancer.

To find out where the bleeding is coming from, it's advisable to take a colonoscopy, which explores the inside of the intestine, under sedation, with a low risk of complications. The colonoscopy reveals the origin of the bleeding, and, as a result, leads to an early diagnosis or the extraction of a polyp, which, even if it is benign, could turn into a cancerous lesion.

Symptoms

Depending on the location of the tumour inside the large intestine, the following symptoms may be present:

  • Blood in faeces: this can be red, most often with tumours at the end of the colon, or black, which causes black stools known as 'melena', which tend to appear when the tumour is located at the start of the colon. A loss of blood can result in anaemia.
  • Abdominal pain.
  • Changes in bowel movements: diarrhoea, constipation or a combination of both.
  • The feeling of an incomplete stool passage. Thinner stools caused by the constriction of the intestine.
  • Other generic cancer symptoms: tiredness, weight loss for no apparent reason, etc. If any of these symptoms appear, you should see a doctor to assess the cause and, if necessary, receive the necessary treatment.

     

Treatment

If a diagnosis of colon cancer is confirmed, and once you know the stage of the illness, your doctor will plan the most appropriate treatment. The treatment, as with most cancer treatments, is multidisciplinary: multiple experts, working on the basis of scientific experience, collaborate to offer the patient the best chances of recovery. The most frequent kinds of treatment are surgery and chemotherapy.

Prevention

Prevention is based on eliminating or removing risk factors that increase the chances of suffering from the disease. Factors that can increase the chance of suffering from colorectal cancers are:

  • A diet that is poor in fibre and animal fats (red meat).
  • A lack of physical activity.
  • Tobacco and alcohol consumption.
  • The presence of inflammatory bowel disease (ulcerative colitis or Crohn's disease).
  • Family history. In 5% of cases of colon cancer, genes are detected whereby their alteration leads to syndromes in which bowel cancer is more likely to appear. The two most significant examples are familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer.
  • Personal history of adenomatous polyps.

People with a high risk of intestinal diseases, or who have a family history of such due to genetic alterations, must monitor their situations closely to facilitate early diagnoses.

Anybody can prevent bowel cancer by improving their health routines: increase fruit and vegetable consumption, limit the amount of animal fats consumed, avoid obesity, moderate alcohol consumption, do not smoke and ensure regular physical activity.

Early detection programme for bowel cancer

Bowel cancer screening is aimed at medium-risk people, that is men and women between 50 and 69 who have no personal or family history of the disease. This way, people who have a prior history of bowel cancer, or with a family history of bowel cancer, are excluded; instead, they are subject to specific monitoring, as they are considered to have a high risk.

This consists in a faecal blood test every two years. If no blood is detected in this test, it's unlikely to be a case of bowel cancer. After two years, the person is invited to join the programme.

DKV will gradually extend the programme to all MUFACE beneficiaries. Nevertheless, if you're in the target population (50-69 years old without personal experience or a family history of the disease) and want to take the test, enquire at your health centre or general doctor.

More information
Spanish Cancer Assocation: Colon cancer