Colorectal cancer screening isn’t glamorous, but it could save your life

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Regarding colorectal cancer screening, there are good students. Like Philip, 51: “Simple, quick to make and easy to ship. As soon as I received my kit after ordering online, I did a test at home. The result came back negative. I’d do it again in two years, it’s worth it. Or Elizabeth, 52 years old and two tests on the clock, who says: “Shortly after my 50th birthday, I received an “invitation card” and immediately made an appointment with my doctor to collect a screening kit. I immediately took the test. Last year, I picked it up at the pharmacy. As with breast cancer, I Seems like it’s always fun to get negative results.”

And then there are others. Those with little or no knowledge, those not worried, those embarrassed about the location of the cancer or having to get tested, those afraid of a positive result or possible additional tests, or those who say that, because previous tests were negative, a new test There is no point in doing so.

“There are really two main barriers to screening, Explains Doctor Stéphane Corcia-Meffre, medical editor who was coordinator of the France Cologne Association until its dissolution. On the one hand, there is the fact that people are reluctant to handle their stool. And on the other hand, the fact that their doctor doesn’t wake them up enough. Furthermore, it is a cancer that remains taboo and is not subject to proper recognition, as is especially the case with breast cancer.

For those who lack information or who delay – and there are many of them, since only 34.3% of concerned people undergo a colorectal cancer screening test and 50% of colorectal cancer is diagnosed at an advanced stage -, a little update is necessary.

What is it about?

Let’s start by identifying the enemy first. Affecting 47,000 people each year, mostly over the age of 50, is colorectal cancer, as the National Cancer Institute website explains. “A disease of the cells that line the inner lining of the colon. It initially develops from a normal cell that mutates and multiplies chaotically, until it forms a mass known as a “malignant tumor” (or “cancer”).

In 60 to 80% of cases, it follows a benign tumor, called a “polyp,” that turns into cancer, a process that lasts five to ten years. These first develop locally, then the cancer cells can migrate throughout the body and metastasize, especially to the lungs and liver.

If, for those with hereditary risk factors, follow-up is close, for all others, age is considered the main risk factor.

“Risk factors are known: age over 50, personal or family history of colorectal cancer or polyps, certain diseases (Crohn’s, ulcerative colitis, acromegaly, Lynch syndrome, genetic diseases, etc.) and lifestyle habits, such as a rich diet. Animal fat or excessive red meat or alcoholic beverages, physical inactivity, overweight and smoking.Dr. Hepato-Gastroenterologist at Nimes University Hospital. Ludovic Caillo explains.

If, for those who present hereditary risk factors or are associated with specific diseases, the follow-up is close and certain examinations are offered from the beginning, for all others, we believe that age is the main risk factor. This is why screening is routinely offered starting at age 50 and every two years.

Track the invisible blood

Before getting into practical considerations, let’s see what this test is for. “A tumor that develops in the colon or rectum is a small vascularized ball. Without initially producing symptoms, it can bleed, which causes the presence of blood, invisible to the naked eye, in the stool., Dr. Caillo explains. So the aim of the test is to detect this presence for early detection of possible cancer.

“The earlier cancer is detected, before symptoms appear, the better it is treated”Recommends a gastroenterologist, who adds: “Five-year survival for people with localized cancer is 90% while for people with advanced cancer, ie with metastases, is 14%.” But be careful: the presence of blood in the stool does not mean that there is cancer. “It could be hemorrhoids, diverticula, peptic ulcers or polyps”

Dr. cites Caillou, who suggests that only four out of a hundred positive tests correspond to cancer.

This is why, if the test is positive, you should not stress unnecessarily and make an appointment with a gastroenterologist to perform a colonoscopy, a reference examination to visualize the interior of the colon and rectum. It makes it possible to detect and remove potential polyps before they transform into cancer, or detect cancer at an early stage, which can be treated with surgery.

It is carried out under general anesthesia, using an endoscope (a flexible tube equipped with a small camera, a lamp and, if necessary, surgical instruments) inserted into the anus to find the lower part of the intestine. “It is a routine, painless and safe test”, Dr. assures Kylo. It is clear that, in recent years, there have been clear advances in the products used to prepare the examination, so that small “empties” are necessary so that the mucous membrane of the colon and rectum can be better seen.

Test, in practice

Let’s go back to the practicalities of colorectal cancer screening tests. In principle, from the age of 50, you receive an invitation to collect a free screening kit from your CPAM, either a doctor (general practitioner, gynaecologist, gastroenterologist or health examination center of the scheme General Health Insurance (CES)) or your pharmacist, Or to order for free via the website monkit.depistage-colorectal.fr. If you don’t get anything, you can contact the doctor or pharmacist directly.

Once you receive the kit, it’s up to you. As you can see below, it’s easy (and don’t worry, you won’t need to touch your wound).

For all practical purposes, Octave, 59, gave us little, testifying to his habit of testing every two years. Tip: “The paper thing that is supposed to stick to the edges of the bowl and that is supposed to hold the stool to prevent it from falling into the bowl never works. It punctures, tears or peels every time. My personal method: two or three sheets of newspaper in a bowl, in which I defecate. Once the sample is taken, I roll the newspaper into a ball, put it in a trash bag, and flush it in the trash (not the toilet, as it will clog with the newspaper).

Once the test is conducted, all you have to do is send it to the responsible laboratory for analysis, using a pre-identified T envelope. You will receive your results within the following days by SMS or failing that, by post. If, as in 96% of cases, the test is negative, there is nothing you can do. See you in two years—unless, of course, in the meantime, you develop symptoms like blood in the stool, unwanted weight loss, or new digestive problems. On the other hand, if the test is positive, you will need to undergo a colonoscopy, as we said.

Let us emphasize the fact that this colonoscopy and the preparation before it is neither fun nor glamorous, it can save lives and avoid heavy and difficult treatment. “When the cancer is still localized, surgery may be sufficient to treat it, while when the cancer is in an advanced stage, chemotherapy and radiotherapy must be used.”Dr. Caillo points out.

In the future, early detection of colorectal cancer and its treatment at an equally early stage will be possible thanks to the use of AI – an innovation already practiced at the Eastern Paris Cancer Center as part of a study – and thanks to robotic surgery to resect tumors.