Life-saving screening - all about colon cancer screening

Author: Davor Kust MD PhD

Sometimes the simple things we do in our own lives and for our own health can have long-term positive effects. One of these is joining a colon cancer screening program. A very simple stool test for occult blood is truly a test that can save your life.

What is screening? It is about introducing simple diagnostic tests in those populations where a disease is widely present. Unfortunately, the above can be said for colon cancer, which is the most common malignant tumor in Croatia for both sexes. It is also a fact that the chances of cure are better the earlier the disease is detected. The point of screening, or early detection of the disease, is precisely that - not to prevent the disease, but to detect it as early as possible in order to enable as many patients as possible to be cured.

As we previously wrote in the article on colorectal cancer where you can read all other information about this disease, in Croatia in 2008 the National Program for Early Detection of Colon Cancer was launched, with the aim of detecting this disease at the earliest possible stage and consequently lower mortality. According to the aforementioned program, all people aged 50 to 74 are referred for a fecal occult blood test every two years. It is important to clarify that screening is carried out in people who do not have any symptoms. In the event that a person has symptoms that can be associated with the disease, the diagnostic workup goes in a different direction to discover the pattern of the problem. Unfortunately, in general, despite all the benefits, the response to screening in Croatia has been very low so far.

When should I start screening?

About 90% of cases of colon cancer occur in people over 50 years of age, so this is the recommended age when the average person should start screening. However, in people with a genetic predisposition or other reasons that increase the risk of developing the disease, screening can begin earlier. Examples include people who have a close family member who has had colon cancer, people who suffer from inflammatory bowel diseases (Crohn's disease or ulcerative colitis), and people with genetic syndromes such as familial adenomatous polyposis (FAP) or Lynch syndrome. The test can also be performed after the age of 75, but an individual approach is required. Contact your oncologist for more information.

What tests are performed?

There are several types of tests used in the world, but the most commonly used is the occult blood test, as in Croatia. During this test, the patient receives a test at home and, using a swab or brush, takes a small sample of their own stool and then sends the test back for analysis. In the laboratory, the sample is tested for the presence of blood that cannot be seen with the naked eye (hence the name "occult" bleeding). Namely, the presence of blood in the stool can be one of the earliest signs of colon cancer. The image shows a positive test result.

Figure 1. Colorectal cancer screening.

Of course, the test itself cannot confirm the presence of the disease with 100% certainty, and people with a positive test for occult blood require further work-up to confirm or rule out the disease. Not all patients with a positive test actually have colon cancer. In further diagnostics, an endoscopic examination of the intestine (colonoscopy) is most often used. During a colonoscopy, the doctor inserts a long, thin,

flexible tube with a light and camera at the tip through the anus. The doctor examines the inside of the intestine through the screen, and if necessary, can remove polyps and smaller tumors in the same procedure. In the event that a larger tumor is found that cannot be completely removed during the colonoscopy, a small tissue sample will be taken for analysis and confirmation of the disease, so that appropriate treatment can be carried out later.

Finally, let's repeat once again, the fecal occult blood test is a simple test that the patient can perform at home, and it can save a life. Why not do it?

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