The latest statistics show that among the top 6 high-incidence cancers in China, digestive tract cancers account for 4. In recent years, the incidence of gastrointestinal tumors has been on the rise. How to prevent gastrointestinal tumors?
Recently, at the "Inescapable Gastroscopy" science popularization activity jointly organized by the Colorectal Cancer Special Committee of the Chinese Anti-Cancer Association, many experts shared the doorway away from gastrointestinal tumors.
Polyps are the "seed" of cancer
"Polyps are the seeds of cancer, and if a colonoscopy is done in time to find a polyp and remove it, the cancer will be killed in the cradle." If you do early screening for bowel cancer in time, you may not be able to get bowel cancer for a lifetime. Lin Guole, chief physician of the colorectal specialty group of basic surgery at Peking Union Medical College Hospital, said that it generally takes 5-10 years to change from intestinal polyps to bowel cancer. Whether a polyp will develop into cancer has a lot to do with its size, and polyps less than 1 cm have a chance of becoming cancerous only about 1%; 1-2 cm polyps, the chance of cancerous is about 5%; Polyps larger than 2 cm have a 30%-40% chance of becoming cancerous.
Lin Guole introduced that polyps are divided into two types, one is non-neoplastic polyps, such as inflammatory polyps and hyperplastic polyps; The other is neoplastic polyps, also clinically called adenomas, which are divided into tubular adenomas, villiform adenomas and mixed adenomas. The chance of tubular adenoma becoming cancerous is about 5%, and the chance of villous adenoma becoming cancerous is more than 20%.
"It should be noted that polyps with a diameter of more than 1 cm and polyps with villi components are classified as advanced polyps." Lin Guole said that after colonoscopy, if the results are normal, it can be examined again after 3-5 years, and if progressive polyps are found, colonoscopy should be repeated within six months to one year after resection.
"The occurrence of bowel cancer is closely related to a person's age, family history, genetic diseases, history of bowel disease, history of other cancers, living environment and habits, etc., and bowel cancer is a preventable cancer." Lin Guole said that in the absence of any symptoms, colonoscopy should generally be performed at the age of 40 or at most 45 years old, especially in the following people: first-degree relatives have a history of colorectal cancer; I have a history of cancer; I have a history of colorectal polyps; 6 of the following 2 conditions: history of chronic constipation, history of chronic diarrhea, mucus and bloody stools, history of adverse life events, history of chronic appendicitis or appendectomy, history of chronic cholecystitis or cholecystectomy; If fecal occult blood or multi-target DNA test is positive, early screening for bowel cancer should be done in time.
According to the "Survey on the Status of Diagnosis and Treatment of Patients with Intermediate and Advanced Colorectal Cancer in China", before the disease, more than half (64%) of patients did not understand the high-risk factors of colorectal cancer at all, and 85% of patients did not understand the knowledge of early screening of colorectal cancer. 97% of patients did not have colonoscopy screening, of which 86.5% did not have colonoscopy screening mainly because they did not know the need for regular colonoscopy screening; At the time of first diagnosis, 83% of colorectal cancer patients were in the middle or advanced stages; Only 6.9% of patients were found on active physical examination.
"I especially understand why people are reluctant to do colonoscopy: some people are afraid of pain, and I am afraid of pain, but I feel okay and tolerated after colonoscopy; At the same time, it was more uncomfortable to take laxatives before colonoscopy, and I also forced myself to swallow; Some people have a fluke mentality, feeling that cancer is far away from them, in fact, everyone may get cancer; Some people learn that painless colonoscopy requires anesthesia, and worry that anesthesia will make people stupid, this worry is superfluous; Some people are afraid of trouble, and they retreat when they think that they need to register and queue for colonoscopy; Some people are afraid of spending money, but if they have cancer, radiotherapy and chemotherapy need to cost more money. Lin Guole said that today's early screening technology has the potential to help people avoid bowel cancer, and suggested that the public, especially high-risk groups, take action to actively prevent bowel cancer.
There are "three taboos" to prevent digestive cancer
Qi Haimei, chief physician of the Geriatric Center of Beijing Hospital, received an elderly couple, and after examination and diagnosis, both elderly people had early cancer. "Under one roof, on a dining table, the two have lived together for decades, and there must be a common factor that causes them to develop cancer." After Qi Haimei asked, he found that the old couple was salty, and they never left the table every day, could not do without salted dried fish, and also liked barbecue foods such as lamb skewers and fried foods; Due to fear of obesity and diabetes, the old couple rarely eat carbohydrates; Due to the fear of stuffing their teeth, the old couple also ate less vegetables and coarse grains. "The old couple eats with the children, makes a lot of dishes every night, and eats endless meals, the old couple saves them for noon the next day, often eating overnight dishes and leftovers, which is also one of the carcinogenic factors."
"There are 'three taboos' for preventing digestive cancer: to prevent stomach cancer 'salty', to prevent bowel cancer to avoid 'greasy', and to prevent esophageal cancer to avoid 'hot'." In Qi Haimei's view, cancer largely comes from "eating", and one of the risk factors for colorectal cancer is the "three highs and one less" eating habits. "Three highs" are high salt, high fat, high protein, and "one less" is less dietary fiber. "My old couple and I did a review, and they said that after going back, they must stay away from the 'three highs and one few' eating habits and try to avoid cancer again." Qi Haimei said.
"Colonoscopy is known as the 'gold standard' for bowel cancer screening, and prevention of bowel cancer should start at a young age, and in general, cancer screening should be done from the age of 40. A middle-aged man who visited the clinic said that his father died of rectal cancer at the age of 53, and he himself was diagnosed with rectal cancer at the age of 53, and he was worried that his child would also fall into the clutches of rectal cancer at the age of 53. "People with a family history need to prevent cancer earlier, generally starting screening 10 years before the age of onset." For example, if the first person in the family has bowel cancer at age 45, a first-degree relative should start screening at age 35. ”
Chronic diseases do not occur suddenly, but are discovered suddenly
"My patients often ask me a word, Doctor, I am usually very healthy, why did I suddenly get such a serious illness? I tell them that all chronic diseases do not occur suddenly, but are discovered suddenly. Bo Shining, deputy chief physician of the Department of Critical Care Medicine of Peking University Third Hospital, said that there are two core reasons why people get cancer: one is genetic mutation, and the other is immune escape.
"Aging is the highest risk factor for cancer. Theoretically, everyone can get cancer as long as they live. Bo Shining said that American research data show that from about the age of 40, the incidence of cancer has increased exponentially, and the lifetime risk of cancer is 41%-42%, "Life is so beautiful, everyone wants to live well, and active regular screening is the best protection for life." ”
"Why do gastrointestinal endoscopy? There is a saying in the digestive world called 'find a case of early cancer, save a life, and make a family happy'. In gastrointestinal cancer, the 5-year survival rate of advanced patients is less than 30%, while the 5-year survival rate of patients with early cancer can exceed 90%, which is the significance of discovering early cancer. Zhang Yi, deputy chief physician of the Department of Gastroenterology and Digestive Endoscopy Diagnosis and Treatment Department of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, said that the clinical definition of early cancer is that the lesion only invades the mucosa and submucosa, but does not reach the muscular layer. In the early stage of cancer, endoscopic submucosal dissection can be used, and the patient can be cured without surgical surgery.
"Screening for gastrointestinal tumors is often overlooked during routine physical examinations." Zhang Kai, deputy director of the Cancer Prevention Department of the Cancer Hospital of the Chinese Academy of Medical Sciences, pointed out that for healthy high-risk groups, gastrointestinal endoscopy is not just needed, so it is often overlooked. He suggested the introduction of non-invasive initial screening techniques before gastrointestinal endoscopy.
In view of the relatively insufficient supply of colonoscopy, some cancer screening institutions and populations have chosen Chang Weiqing, which is a method of colorectal cancer screening by detecting stool, and you can take samples at home and send them for testing.
"In the past, some patients wanted to have a gastrointestinal scope, but they couldn't do it because they couldn't drink laxatives. At that time, I thought if there was something like screening for early pregnancy. Qi Haimei said that now with early screening products such as Chang Weiqing, people can sample feces according to the instructions at home, send the samples out, and soon use mobile phones to see the results, which is more convenient for the elderly.