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Patients are reluctant to even use free colonoscopy tests, despite the fact that in this way it is possible to detect not only cancer, but also precancerous conditions of the large intestine. Hence the proposal to replace it in the screening program with a modern FIT fecal occult blood test, and only refer patients to colonoscopy in the event of a positive result.
- Colorectal cancer develops in the colon (large intestine) or in the rectum, which is the end of the colon
- Cancer takes 1 million people around the world every year
- In the first stage of the disease, 90 percent diagnosed patients have a chance of survival. In the fourth stage, the chances drop to 10 percent.
- Colonoscopy can detect the disease even before the appearance of cancer symptoms. It is especially recommended for those whose relatives have suffered from colorectal cancer
- An alternative may be the soon available non-invasive examination – FIT test, which allows you to capture occult blood in the stool
- More information can be found on the Onet homepage
Colonoscopy – what is this test?
Colon cancer it is the second leading cause of death from malignant neoplasms, which means, that a million people worldwide die from this disease in a year. This is despite the fact that there are effective screening techniques that can significantly reduce mortality.
One of them is colonoscopy – a test that combines elements of diagnosis and treatment. Through a special speculum inserted into the lower digestive system, the doctor can carefully examine the intestinal mucosa. In many situations, it can also remove polyps – those changes in the intestine that can become malignant over time. Such removal is giving life – the patient will not get cancer. In the case of more advanced changes, the patient is referred for appropriate treatment.
– The test is used to detect the disease even before its symptoms appear. However, a lot of myths have arisen around the colonoscopy, as a result of which many people have their own, often wrong, idea about the course of this study – says Prof. dr hab. Jarosław Reguła, national consultant in the field of gastroenterology, working at the Department of Oncological Gastroenterology of the National Institute of Oncology – National Research Institute.
Six reasons to overcome the fear of a colonoscopy
Patients’ fears lead them to drop out of the study. Only about 20 percent of the respondents apply. people who are invited to free screening.
Concerned about this fact specialists propose to replace colonoscopy with a modern fecal occult blood test at the first stage of screening – FIT (the. fecal immunochemical test). It falls out positively in 10 percent. people who need a colonoscopy. In negative individuals, the FIT test is repeated every two to three years.
– The effectiveness of this test in detecting cancer is very good; slightly smaller in the case of adenomas, but much larger than the older type of occult blood test used until recently – says Prof. Rule.
The FIT test contains specific antibodies against human blood proteins. It is specific for bleeding from the lower gastrointestinal tract.
– If the bleeding comes from the upper part – stomach, small intestine – the test is negative because blood proteins are digested by digestive enzymes and are no longer present in the large intestine. What is important, the FIT test result is not affected by any dietary components or medications – explains the specialist.
Performing the FIT test for screening starts after the age of 50 and repeats every two years. In Poland, this modern faecal occult blood test is currently only commercially available.
Examples from other countries
The proposal of Polish specialists is not a novelty, because such a procedure is used in many countries, and in the near future, a European Union recommendation is to be published that the FIT test should be the first-choice method in screening for colorectal cancer. Also in Poland there is a green light: the test has been approved by the Agency for Health Technology Assessment and Tariff System AOTMiT.
Inflammatory bowel disease – can it be prevented?
– We propose that the colonoscopy should be the first test only for people with a strong family history, while for the general population we will propose the FIT test. It would then be possible to screen the entire population: send tests to selected people as part of screening tests or ask them to collect the test from the pharmacy, and colonoscopy should be done only to people with a positive test result – explains Prof. Rule.
In his opinion, this solution has a chance to work. This was also demonstrated by the PICOLINO pilot, which was carried out under the supervision of Dr. Nastazja Pilonis at the National Institute of Oncology from the end of 2018 to March 2020 using the FIT test as an alternative to colonoscopy. The reporting rate was 60 percent higher. So there is something to fight for.
– We hope that in one or two years we will completely switch to the FIT test, and during this time we will terminate the colonoscopic screening program – says the national gastroenterology consultant.
M2PK is an enzyme whose increased amount may indicate the presence of rapidly dividing cancer cells, incl. in the large intestine. It can be detected by a test that you can do yourself at home. You will find them in Medonet Market.
Temporary troubles
For now, however, the matter has become a bit complicated – not all legislative and organizational changes to introduce this program have been prepared yet, and at the same time – due to the change of payer (the screening program for colorectal cancer so far financed by the Ministry of Health has passed under the NFZ), colonoscopic screening examinations have been discontinued. It means that as of January 1, 2022, screening has completely stopped.
Director of the Department of Treatment in the Ministry of Health, Michał Dzięgielewski during a press briefing accompanying the opening in the Sejm of an educational exhibition on colorectal cancer entitled “Colonoscopy is not the cosmos,” he said, “at the moment, there is a regulation in consultation that will constitute a prevention program and this time it will be a permanent program for many years, as it is included in the NHF services package«.
Author: Monika Wysocka, Zdrowie.pap.pl
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