colorectal cancer screening | COLORECTAL CANCER (BIG INTESTIN) - EXAMS

COLORECTAL CANCER (BIG INTESTIN) - EXAMS




WHOLESALE CANCER (COLORECTAL) CAUSESSYMPTOMSEXAMENSTRAITEMENTS
Screening for colorectal cancer
In the Wallonia-Brussels Federation, an organized Colorectal Cancer Screening Program has been operational since March 2009 for the population between 50 and 74 years old. Today it is a regional competence.


Dr. Marc Polus insists on the usefulness of colorectal cancer screening


Also read the interview of Prof Coche, published in March 2015 in our magazine Together Against Cancer. Prof Coche is one of the initiators of the colorectal cancer screening program in the Wallonia-Brussels Federation.

Read more about the benefits of screening for cancer.

Who is involved in colorectal cancer screening?
Colorectal cancer screening is for men and women aged 50 to 74 years. It has been organized by the Wallonia-Brussels Federation since 2009, and since 2014 in Flanders. For Brussels and Wallonia, a new test has been used since February 2016. It is the immunological test (iFOBT, for Immunological Faecal Occult Blood Test) which is much easier to perform than the Hemoccult® test previously used. Instead of 3 bowel movements, you only need to make one. In addition, the immunoassay is even more reliable. This test is already used in Flanders since 2014.

How is colorectal cancer screening conducted?
Through the stool search for traces of blood invisible to the naked eye (immunological test).

If you are between 50 and 74 years old and you do not have any particular risk, a letter of invitation is addressed to you personally:

within two years after your 50th birthday,
5 years after a negative colonoscopy.
In the mail, you will be invited to visit your general practitioner to receive the test to do at home. This test is free, only the consultation is to pay. The advantage of going through the doctor is that he can establish your risk profile and give all the necessary explanations. However, once you have done the test a first time and if the result is negative, the second test will be sent directly to you by mail.
If you want to do the colorectal cancer screening test without waiting for the letter of invitation, talk to your doctor.

From now on, only one stool sample is enough. You then return the test by mail.

The results will be sent to you and your doctor. In about 97% of cases, the test is negative (that is, no traces of blood were detected) and the person is reassured.

If the test is positive, your doctor will suggest a colonoscopy (or colonoscopy) to check the cause of the bleeding. This one can have several causes. If it is a pre-cancerous lesion (or "polyp"), it can usually be removed immediately during the exam and you will avoid it degenerates into cancer. If it is a cancer, it is probably still at a beginner stage. By taking the test, you have taken things on time with a lighter treatment and a better chance of healing!

What does 'not having a particular risk' mean?
Your GP will check your level of risk.

If the risk is:

medium (ie for people aged 50 to 74, asymptomatic and without particular factors), this test should be done every two years. In case of a positive result, your doctor will offer an examination of the inside of the colon and rectum (colonoscopy).
high or very high (ie for those with a family or personal history), your doctor will invite you to go to the gastroenterologist for the development and completion of a full colonoscopy.
More information on this subject on the website of the Community Reference Center for Cancer Screening.

Screening by immunoassay
It consists of a search for blood not visible to the naked eye in the stool.

A cancer of the large intestine is often accompanied by small blood loss that is not always visible to the naked eye. These microscopic bleeding can be discovered by stool sampling to perform an immunoassay.



Illustration from the JRC website: www.ccref.org/contexte-colon.php

Other screening tests
Other tests may be performed if the presence of colorectal cancer is suspected.

Rectal touch
A finger is introduced into the rectum to palpate its wall. This examination makes it possible to locate a tumor located near the anus.

endoscopy
An endoscope is a thin flexible hose that contains an optical system and a lighting system. This examination makes it possible to observe the walls of the cavities of the body or hollow organs. If an endoscopy is necessary, the intestine is first emptied of its contents (taking a laxative and followed by a diet without fibers). The endoscope is then introduced through the anus.

If the device is ascended to the sigmoid, the examination is called rectosigmoidoscopy.
If the entire large intestine is examined, it is called colonoscopy or colonoscopy.
Thanks to the endoscope, you can take a small piece of suspect tissue (polyp, for example). The collected sample (biopsy) is examined under a microscope to determine its exact nature. Microscopic examination will provide certainty as to the presence of colorectal cancer at this location.

endoscopy

X-ray or colo (no) virtual scans (scanner)
Examination of the large intestine is possible by conventional radiography or CT scan (virtual colonoscopy). Both techniques involve taking laxatives and following a fiber-free diet to completely empty the large intestine. This is essential to properly visualize the intestinal wall and identify any abnormalities.

During the examination, air is blown into the large intestine by a rectal probe to visualize the entire intestinal wall as well as possible. In case of conventional radiography, a contrast product is introduced by the rectal probe.

Diagnostic examinations
If the diagnosis of colorectal cancer is made, the doctor asks for further examinations in order to specify the degree of local development of the tumor.

Classification colon cancer tumors

Some exams give an idea of ​​the tumor invasion inside the intestinal wall (very important to define the stage of the disease) and allow to identify anomalies (possible metastases) in the lymph nodes which surround the large intestine:
a transrectal ultrasound (an ultrasound probe being introduced through the anus) for rectal cancer
CT-scan or nuclear magnetic resonance (NMR or MRI)
An extension assessment is then carried out, in search of possible distant metastases of colorectal cancer. This assessment includes an examination of the liver (ultrasound, CT scan or nuclear magnetic resonance) because when colorectal cancer becomes widespread, it often invades the liver.

A chest X-ray is also performed, especially in cases of rectal cancer, in search of possible pulmonary metastases.

If one or more of these colorectal cancer diagnostic accuracy exams are prescribed, do not hesitate to ask for explanations on why and how. Depending on the results of the assessment thus made, appropriate treatments may be proposed.