The test that can reduce mortality in colon cancer by up to 30%

• World Cancer Day Diagnostic techniques in cancer that prolong life

• Cancer precision medicine: the future depends on the genetic profile of the tumor, not only on the organ where it originates

Colon cancer is the second leading cause of cancer death in Spain after lung tumour.

programs

that analyze

are aimed at people

of age with the aim of detecting the

at an

.

Properly implemented, screening

short-term mortality from the disease by between 30% and 35%, according to the

(AECC).

To promote this type of test, the association has launched today, March 31, World Colon Cancer Day, the campaign

.

With it, the AECC invites the population to

in the screening programs in Spain and remember that this other test (which has nothing to do with the Covid-19 test) "can help overcome this type of tumor in 90% of cases if it is detected in time" .

The

(SEOM) corroborates this, by placing the detection of cancer in early stages as one of the favorable prognostic factors: "Five-year survival of patients with early-stage colon cancer exceeds 90%, while in

it is around 50-70%".

For this reason, they indicate from the SEOM, "the screening programs that the autonomous communities have been implementing

are essential to reduce mortality, estimating that

from colorectal cancer and save more than 3,600 lives a year in our country.

The efficacy of the fecal occult blood test is unquestionable.

The AECC collects data from the Population Program of the Basque Country, which has shown an increase in five-year survival of 23.4% in the people participating in the screening programs.

Access the benefit of early detection

The Basque Country is, along with Navarra, a model community in the execution of this screening, which began in 2009 with pilot experiences that have been expanding little by little, but it seems that not enough.

This is highlighted by

, head of the Liver and Gastrointestinal Diseases Area of ​​the Biodonostia Institute, who explains that "in 2014, in the Basque Country, the

to participate in screening reached 100% of the

(people from 50 to 69 years old).

On the other hand, in 2017 there were still communities where not even 50% of the population had been invited". Bujanda acknowledges that it is difficult to quantify the differences between communities, because there is no accessible official data, but he points out that "while in the Basque Country we were by the fifth round, other communities have not yet reached their entire population goal.

These are important

, because they imply that there are

from

of colorectal cancer.

70% of colon tumors detected in screening programs are early and can be cured with endoscopy, without the need for surgery or chemotherapy."

The "successful" approach in the Basque community, according to Bujanda, Professor of Medicine at the UPV/EHU and president of the Foundation of the Spanish Association of Gastroenterology, consists of sending the invitation to the screening

(more than 70% participate of the invited population).

In other communities, such as Catalonia, the protocol has the

, where the samples are collected.

Once the fecal occult blood test is done, if the result is positive, a colonoscopy is carried out to find out the source of the bleeding.

If it is negative, a new test is called in two years.

In order to achieve the positive impact of screening programs, it is necessary to reach a participation of the target population of over 65%, they affirm from the AECC

.

Only Navarra and the Basque Country exceed this participation, with 73% and 72% respectively.

"Below these percentages is La Rioja, with a 60% share and, at the opposite extreme, Ceuta, with 22%, which shows the variable share depending on the autonomous community" and, therefore, , inequality in prevention.

The Association recalls that "only

knows of the

of

programs , with colonoscopy being the main diagnostic test known for colon cancer. Regarding the FOBT test [test of fecal occult blood] as a diagnostic method,

about it, which makes the level of participation in early detection tests very low".

Another way to measure the positive effect of screening is to study what happened during the initial months of the Covid-19 pandemic, when participation in this type of preventive campaign declined.

A

(with the participation of more than 20 hospitals and led by Rodrigo Jover, head of the Digestive System Service at Alicante Hospital) presented at the recent congress of the Spanish Association of Gastroenterology, compares data from a year prior to the pandemic with the subsequent year since its inception.

The preliminary results presented show that 34% fewer colon cancers were diagnosed in the post-Covid era.

With the

, the number

of

it dropped

in the year before

.

For Bujanda, "this translated into a greater tendency to perform surgery and more chemo-radiotherapy, ultimately, to a worse prognosis in diagnosed tumors."

The professor points out that in addition to expanding coverage and participation, as strategies to improve these screenings, research is being carried out on new

to identify certain genetic and intestinal microbiota profiles in occult blood that "help us detect polyps that can end up generating a cancer."

The most frequent tumor in 2022

Colorectal cancer will be the most frequently diagnosed tumor in Spain in 2022 globally with

-26,862 in men and 16,508 in women-, according to the SEOM.

"When we break it down by sex, it is surpassed by prostate cancer in men -30,884 cases- and breast cancer in women -34,750 cases-. In 2020 it was the second leading cause of death from tumors (15,125 deaths), only by behind lung cancer (21,918 deaths), detailed from the scientific society.

In non-initial stages, surgery, chemotherapy and

are the three basic pillars of approach.

The latter is essential in the cure of

that have not developed metastases, but are large or have infiltrated nearby lymph nodes.

According to

, coordinator of the Digestive Tumors Working Group of the

(SEOR), "in highly selected cases it is even capable of curing the tumor."

Also, in people who have developed

of colorectal cancer, this radiation oncologist at the HM Sanchinarro University Hospital and the HM Puerta del Sur University Hospital (Madrid) indicates that "radiotherapy can be a very effective alternative for the treatment of liver, lung or lymph node metastases, something that, in cases with a limited number of metastases, it has been shown to increase their survival."

It may also be useful in some patients "improving their

by being used to control symptoms such as pain or bleeding.

tumors

, there are also various treatment options.

According to SEOM, "20% of patients who receive metastasis surgery do not show signs of disease at five years. In addition, retrospective analyzes have shown

after surgery for metastases of up to 70%, which is a milestone and a great advance in our days".

Medical oncologists also highlight the role that so-called

has played in the treatment of advanced colorectal cancer in recent years "Until now it has made it possible to detect different

from patients such as those with RAS mutation, HER2 amplification, fusions/rearrangements, and BRAF mutations.

These patient populations could be considered for specific treatments through

developed based on the molecular alteration existing in each of them." And they hope that the increased knowledge of the environment that surrounds neoplasms from the point of view of the microbiome, among other factors, "could lead to a better approach to the disease.

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