Colorectal cancer is a common malignant tumor in China. In western developed countries, the incidence rate of colorectal cancer ranks the 2nd to 3rd in cancer. With the continuous improvement of living standards and changes in dietary habits, the incidence rate of colorectal cancer in China has been increasing year by year, and has jumped to the 3rd to 5th place, especially in large cities.
The incidence rate of colorectal cancer in Shanghai is at a high level nationwide. According to the data released by Shanghai health department in April this year, the overall incidence and mortality rate of malignant tumors in Shanghai is at a high level in China, among which the incidence rate of colorectal cancer is rapidly increasing, with an average annual growth rate of more than 4%.
A fact that cannot be ignored is that colorectal cancer can be prevented. First of all, the occurrence of colorectal cancer is closely related to diet and living habits, so correcting some bad habits can achieve the purpose of preventing the occurrence of colorectal cancer. Secondly, most colorectal cancers develop from precancerous lesions – polyps, which can be detected and removed timely through colonoscopy to achieve the purpose of early treatment and prevention of colorectal cancer.
I. Cancer does not happen suddenly
In recent years, people always talk about cancer and often worry that they will suddenly develop cancer without knowing it. Scientists have discovered through a lot of researches that there is a long process for the development of various cancers, which is to gradually transform from a normal cell into a cancer cell, then gradually proliferate and metastasize to various parts of the body, and finally become difficult to treat. This process can take a few years or more than 10 years, and it never happens suddenly, just that we do not feel it. In fact, we have many opportunities to detect, interrupt and treat various cancers during these years. With the development of modern science and technology, scientists have researched many ways to prevent the occurrence of cancer and cure precancerous lesions and early cancers. At present, for most precancerous lesions and early stage cancers, there is a complete chance to cure them completely, while for advanced cancers, only some of them can be cured. Therefore, cancer is not that terrible, as long as we pay attention to it and detect it in time, many cancers can be not only cured but also prevented from occurring. Colorectal cancer is a very good example.
Second, timely examination can stop the occurrence of colorectal cancer
Colorectal cancer is one of the malignant tumors that can be detected early through population screening and thus reduce the mortality rate internationally. It is found that most colorectal cancers develop from intestinal polyps, which is the evolution process of normal intestine → small polyps → large polyps → heterogeneous hyperplasia → cancer → metastatic cancer, so the polyps are called precancerous diseases of colorectal cancer. It can be seen that if polyps and heterogeneous hyperplasia can be detected and treated in time, the occurrence of most colorectal cancers can be prevented. Currently, colonoscopy can detect most polyps, and it can also remove most of them without open surgery, thus avoiding the occurrence of cancer.
It should be noted that polyps and early cancers are almost asymptomatic, and most of those who go to the hospital when they have symptoms are found to be advanced cancer patients. At present, most of the colorectal cancer patients in Shanghai are late stage at the time of diagnosis, and the proportion of early stage is only 11.8%, and the five-year survival rate is 43%, which is 10-15 percentage points different from that of European and American countries, mainly because of the lack of medical examination and screening awareness. The percentage of Shanghai people who have received fecal occult blood and colonoscopy is very low. According to the monitoring of Shanghai CDC, less than 5% of Shanghai people have undergone fecal occult blood test and only 3% have undergone colonoscopy.
In order to raise public awareness of colorectal cancer screening, control the incidence and mortality of colorectal cancer in Shanghai, further popularize early detection of tumors, and raise awareness of cancer prevention and fighting, the Shanghai government has listed “colorectal cancer screening for community residents” as a major public health service project to deepen the reform of the medical and health system in Shanghai.
There is still a lack of methods to detect early colorectal cancer and precancerous lesions through blood tests, and it is necessary to rely on colonoscopy. Stool DNA test, barium enema angiography and CT simulated colonoscopy cannot be routinely used to detect precancerous lesions and early colorectal cancer.
However, many people have a fear of colonoscopy and are afraid of pain. In fact, this problem can be solved by painless endoscopy and there is no need to worry at all. The examined person can complete the relevant examination under sleep state, and the whole process is comfortable and quiet without any uncomfortable feeling. The endoscopist can complete the examination and treatment calmly, carefully and thoroughly without thinking about the operation time, and reduce the leakage of diagnosis. Modern people are concerned about the quality of life, and painless endoscopy can reduce the anxiety and pain of the examinees, so it has now become a routine practice for health checkups, outpatient and inpatient in developed countries such as Europe and America. At present, the endoscopy room of Gongli Hospital has carried out thousands of cases of painless gastroscopy and colonoscopy.
Who needs to have colonoscopy
The “Guidelines for Screening and Early Diagnosis and Treatment of Major Cancers in China” formulated by the China Cancer Foundation recommends that people over 40 years of age should be screened for colorectal cancer. If more than one first-degree relative or more than two second-degree relatives have colorectal cancer or related tumors, colonoscopy should be done 10 years earlier than the minimum age of incidence in the family, and once every 3 to 5 years according to family history.
It is generally considered that the high-risk group of colorectal cancer includes: ① positive stool occult blood test; ② history of colorectal cancer in first-degree relatives; ③ history of intestinal adenoma in myself; ④ history of cancer in myself; ⑤ those who meet any two of the following six items, chronic diarrhea, chronic constipation, mucus and blood stool, history of chronic appendicitis or appendectomy, history of chronic cholecystitis or cholecystectomy, long-term mental depression.
All polyp-like lesions found in the examination should be biopsied for pathological diagnosis and timely treatment. Some early colorectal cancers can be treated by endoscopy. Endoscopic removal of polyps can prevent the occurrence of colorectal cancer to a certain extent, but it should be noted that polyps have an obvious tendency to recur, so it is also necessary to review colonoscopy regularly.
4.How to prevent colorectal cancer
The rapid increase in the incidence of colorectal cancer is related to changes in the lifestyle of the public, including unreasonable diets with high protein, high fat, less grains, less fruits and vegetables, reduced physical activity and increased overweight and obesity. Improving dietary structure, eating more foods with more fiber, and paying attention to appropriate calcium and vitamin D supplements can help reduce the occurrence of colorectal cancer.
The incidence of colorectal cancer in people with mainly vegetarian diet is significantly lower than that of the general population. Fruits and vegetables contain a large amount of plant fiber. Soluble plant fiber can absorb more water, soften stools and increase stool volume. In addition, vegetables and grains contain a variety of antioxidants, carotenoids, lycopene and folic acid, etc. In this way, they promote intestinal motility and reduce the contact between carcinogens and intestines, and also facilitate the excretion of carcinogens, which shows that the protective effects of a high-fiber diet are multifaceted and comprehensive.
Excessive fat intake can lead to increased incidence of colorectal cancer, but different types of fats have different effects on the development of colorectal cancer. Saturated fats of animal origin are most closely associated with colorectal cancer incidence. Vegetable oils are not associated with the development of colorectal cancer, while fish oil, which is rich in polyvalent unsaturated fatty acids, has a preventive effect on colorectal cancer. Some carcinogens are produced in the process of frying, deep-frying, baking and marinating foods, especially animal fats.
Regular and moderate physical activity, avoiding obesity, limiting calorie intake for overweight people, and quitting smoking and drinking are all beneficial to the prevention of colorectal cancer. The longer and larger the amount of smoking, the greater the chance of colorectal polyps and colorectal cancer. Quitting smoking can reduce the occurrence of polyps. Excessive alcohol consumption can increase the risk of colorectal cancer in men.
Scientists are currently working on chemical drugs that can prevent colorectal cancer, but regardless of the use or non-use of chemical prevention, a scientific diet is the best measure to prevent the development of colorectal cancer.