Avoiding going to the hospital with the concern of getting coronavirus, which has affected our country deeply for about a year, prevents the chance of early diagnosis in colon cancer.
Colon cancer, which ranks third among the cancer types that cause the most deaths in both men and women in our country, is rapidly spreading with the effect of unhealthy eating habits and inactivity, while not having regular screening programs increases the risk. Acıbadem University Medical Faculty Internal Diseases Department Head and Acıbadem Altunizade Hospital Gastroenterology Specialist Prof. Dr. Nurdan Tözün made a statement within the scope of Colon Cancer Awareness Month in March and World Colon Cancer Awareness Day on March 3; He emphasizes that colon cancer can be prevented by colonoscopy to a great extent, while he says that some mistakes about colon cancer delay the diagnosis and treatment of the disease. Prof. Dr. Nurdan Tözün talked about 6 common mistakes about colon cancer and made important warnings and suggestions.
Colon cancer, which ranks third in cancer deaths in both women and men in our country, is a cancer type that can be prevented when the rules are followed and treatment is satisfactory when diagnosed early thanks to colonoscopy. Because cancer develops on the basis of polyp at a rate of 98 percent, and removal of polyps thanks to colonoscopy prevents cancer. On the other hand, avoiding going to hospitals for the worry of getting coronavirus and postponing colonoscopy, especially during the pandemic process, can lead to the diagnosis of colon cancer at an advanced stage! Acıbadem University Faculty of Medicine, Head of Internal Diseases Department and Acıbadem Altunizade Hospital Gastroenterology Specialist Prof. Dr. Stating that 375 thousand people are diagnosed with colon cancer every year in Europe and 170 thousand people die from the disease, Nurdan Tözün stated that “Healthy people aged 50 and over who should be included in the cancer screening program and a significant portion of those who will undergo colon cancer treatment and have a control colonoscopy, They have not been admitted to the hospital for the past year due to fear of Covid-19 transmission. This increased the probability of finding advanced colon cancer according to our experience and some publications. In a study conducted at the University of Bologna in Italy, delaying colon cancer screening for 4-6 months increases advanced colon cancer by 3 percent; A delay of more than 12 months increases this rate to 7 percent. However, it is unknown when the pandemic will leave us, and screening programs should not be interrupted by taking very good measures against the coronavirus. " says.
6 false facts about colon cancer!
Stating that there are some false beliefs about colon cancer in the society, Prof. Dr. Nurdan Tözün emphasizes that these false beliefs prevent the possibility of early diagnosis and cause the disease to reach an advanced stage. Prof. Dr. Nurdan Tözün explained these wrong beliefs and truths in society as follows;
Rectal bleeding indicates hemorrhoid disease, should not be overlooked: WRONG!
ACTUALLY: Most of the patients fear that a bad disease will occur, "I have hemorrhoids, it is probably the cause of bleeding." He does not consult a doctor with his discourse, he follows the advice of his neighbor and turns to alternative medicine. Sometimes, the physician attributes the bleeding to this condition if there is hemorrhoids or fissures (cracks) in the examination, especially in young and chronic constipation patients. However, bleeding from the anus can be the harbinger of a cancer or a large polyp. It is absolutely necessary to examine in detail.
This disease is genetic, there is no cancer in my family: WRONG!
ACTUALLY: 15 percent of cancers occur on genetic background. Having colon cancer in the first degree relatives or having familial colon polyposis increases the risk of developing cancer. However, colon cancer may also develop in people with no family history of cancer. In recent publications, genetic screening of tumor tissue is recommended in non-familial colon cancers.
Prolonged constipation then leads to cancer: WRONG!
ACTUALLY: There is no information that chronic constipation or irritable bowel syndrome causes colon cancer. However, when colon cancer or a large polyp grows large enough to narrow the intestinal cavity, constipation, bowel obstruction or rectal bleeding may occur. People whose bowel habits change in this direction should definitely see a gastroenterologist.
Colonoscopy is a very difficult and painful procedure, it can even be fatal! FALSE!
ACTUALLY: Colonoscopy is a very low risk procedure in specialist hands. Perforation or bleeding of the intestine during colonoscopy is less than 1000 in 1. Before colonoscopy, the patient is evaluated in terms of accompanying diseases and medications are adjusted. (For example; antibiotics, blood thinners, anti-diabetics etc.), intestinal cleansing is performed according to known diseases or body structure, the patient does not feel pain because the procedure is performed under deep sedation (sleep), and general anesthesia is does not need to be applied.
Why should I have a colonoscopy when I have no complaints! FALSE!
ACTUALLY: A person's life-long risk of developing colon cancer is a 6 percent probability that cannot be underestimated. In other words, 18 out of every 1 people can develop colon cancer. It is known that colon polyps and colon cancer are more common in obese people and smokers, those who regularly drink alcohol, those who eat processed food, have colon cancer in their family and those who do not exercise. However, the risk of death from colon cancer decreases by 45 percent with colonoscopy.
There are drugs that prevent colon cancer! FALSE!
ACTUALLY: Although much work has been done on this subject, there is no clear result. Although some studies have mentioned the anti-cancer effects of non-steroidal anti-inflammatory drugs, calcium, magnesium, folic acid, vitamin B6 and B12, vitamin D, statins and aspirin, this effect has not been confirmed in large series. It is said that maybe a marginal favor can be obtained for those who use aspirin for other purposes. There is a long way to go in this regard. It is best to eat a healthy and fiber-rich diet, exercise, avoid smoking and alcohol, and not gain weight.
It is possible to prevent colon cancer; but!
Colon cancer develops at a rate of 98 percent on a polyp basis, and polyps larger than 15 mm in diameter are 15 times more likely to become cancerous than those below 1.5 mm. Stating that removing polyps with colonoscopy prevents cancer, Prof. Dr. Nurdan Tözün; He says that colon cancer screening programs based on various protocols are carried out in almost all European countries today, and in a study conducted in 2000 European countries between 2016 and 16, it was reported that the frequency of colorectal cancer decreased significantly in countries that started screening programs early. Gastroenterology Specialist Prof. Dr. Nurdan Tözün explains how colon cancer screening is performed as follows: “In general, in many countries, occult blood screening in feces is used as a screening method every year or every two years. Some countries accept colonoscopy as the gold standard, which is a more sensitive but more costly method and allows the removal of polyps with precancerous lesions. With today's technology, early colon cancers and polyps can be better recognized with artificial intelligence-based imaging systems. Although colonoscopy is the gold standard in detecting polyps, the success of the procedure; The experience of the person performing the colonoscopy and the compliance with the quality standards in the procedure determine.
Who should be screened?
Emphasizing that the Covid-19 pandemic may continue for a long time, Prof. Dr. Nurdan Tözün said, “For this, by taking measures such as obeying the necessary precautions (mask, distance, cleaning) and getting the Covid-19 vaccine in pandemic conditions; Occult blood test in the stool or preferably a colonoscopy procedure seems to be the most effective and rational way to prevent colon cancer. So who should be screened?
In general, the screening age is considered to be 50 years for people in the average risk group. Screening is done with a sensitive method by examining occult blood in the stool every 2 years and colonoscopy is applied to those who test positive. According to the findings, colonoscopy is repeated 1-3-5 or after 10 years if everything is normal. Although the termination age of the scan is determined as 75, this period can be extended according to the person.
Since early age colon cancer has increased in recent years, it is recommended to start screening at the age of 45 or even 40.
It is necessary to start screening people with colon cancer in their first degree relatives or with one of the familial polyposis syndromes at an earlier age.