The incidence of colorectal cancer in my country has been increasing rapidly since the age of 40, and the rate of increase is more obvious in people over 50.

Doctors recommend that the general population should have a colonoscopy at the age of 40 to check for cancer risk.

　　However, there is a "hidden" colon lesion with a detection rate of only 0.07%, which requires the high sensitivity and high-quality bowel preparation of the endoscopist to reveal the "true face of Mount Lu".

　　Physical examination revealed "common hyperplastic polyps"

　　2 years later, I found out that it was wrong

　　38-year-old Ms. Ma (pseudonym) is a university teacher in a medical school. While teaching and educating people, she usually receives a lot of new medical concepts and viewpoints.

Therefore, Ms. Ma, who has a high awareness of self-protection, had her first colonoscopy at the local hospital before she arrived at the age of 40.

The results showed that a flat lesion with a diameter of about 0.8 cm was seen near the ileocecal valve in the ascending colon.

　　Ms. Ma recalled that the doctor took her a pathological examination at that time, and it was suggested that it was a hyperplastic polyp, so she didn't care much.

"Everyone now thinks that ordinary hyperplastic polyps will not become cancerous, so the doctor said that regular review is enough." Ms. Ma said, "I also checked some relevant literature at that time, and I agree with the doctor's treatment method."

　　But Ms. Ma was always restless.

Two years later, Ms. Ma came to Hangzhou No. 1 People's Hospital for treatment and asked for a re-examination of the colonoscopy.

Sure enough, this time I really found the problem!

　　Another colonoscopy revealed that the diameter of the flat lesions in the ascending colon was 2.5 cm, much larger than 2 years ago. The endoscopist, Deputy Chief Physician Zhou Haibin, judged that this large "hyperplastic polyp" might be a sessile serrated lesion ( SSL), and there may be local dysplasia.

　　Because sessile serrated polyps are at risk of canceration, Zhou Haibin suggested that Ms. Ma should undergo colonoscopy for complete resection with EMR or submucosal dissection with ESD, and told Ms. Ma that surgery, radiotherapy and chemotherapy are generally not required after the operation, and regular colonoscopy follow-up is required. That's it.

　　The captain of the square dance meets the sisters for a colonoscopy

　　7 precancerous lesions detected

　　A 69-year-old Aunt Wang (pseudonym) also encountered a similar situation.

　　Auntie Wang is usually healthy and cheerful. She likes to dance square dance with her sisters, and pays great attention to health care.

On this day, she and her sisters made an appointment to come to a hospital in the city for a physical examination. The examination items naturally included the "highlight" - colonoscopy.

　　Before the examination, Auntie Wang was full of self-confidence, believing that she could eat and drink without digestive tract discomfort, and the abdominal CT scan just last year showed that she was normal, and there would be no problem with the colonoscopy.

As the captain of the square dance team, Aunt Wang even made a rehearsal plan for the team members for the next day before anesthesia.

　　What Aunt Ling Wang did not expect was that many "time bombs" were discovered under the endoscope.

Like Ms. Ma's disease, Aunt Wang's ascending colon and cecum were found to have 7 sessile serrated polyps of various sizes, all of which were very concealed.

　　Under the professional operation of the gastroenterology team of a city hospital, these polyps were successfully removed.

After the operation, Auntie Wang understood the risks of these "time bombs" and was very fortunate that she received timely treatment.

　　Zhou Haibin introduced that the incidence of serrated lesions in the population is 20%-40%, and colorectal serrated lesions can progress to colorectal cancer through the serrated pathway, accounting for 15%-30% of the incidence of colorectal cancer. It is recognized as a new colorectal carcinogenesis pathway in addition to adenoma-carcinoma, inflammation-dysplasia-carcinogenesis, and denovo cancer pathways.

　　Current studies suggest that sessile serrated lesions (SSL) and traditional serrated adenomas have malignant potential, and the time for SSL with dysplasia to develop to colon cancer is greatly shortened, only 7-15 years.

　　Early detection and correct treatment of sessile serrated lesions is an important way to prevent its progression and carcinogenesis.

However, relevant studies in my country have found that the detection rate of SSL is only 0.07%, and many patients have "time bombs" on their backs without knowing it.

　　Therefore, finding and removing these hidden "time bombs" in a timely manner requires patients to have a good sense of health examination and clean bowel preparation, and endoscopists must maintain a high degree of sensitivity during operation.

　　Zhou Haibin reminded that the concept of "no feeling means no disease" and "no pain or itching to see any disease" is outdated. "Early gastrointestinal tumors are asymptomatic, and most of them are discovered accidentally during physical examination."

　　Reporter He Lina trainee reporter Xu Ziying