Colorectal cancer, also known as colorectal cancer, is a malignant tumor of digestive tract. China is a country with high incidence of digestive tract tumors, and the incidence rate is increasing year by year. The early symptoms of colorectal cancer are asymptomatic, and most of them have developed to the middle and late stage when they are diagnosed, which is prone to chemotherapy resistance and focus metastasis, leading to a very high mortality rate of colorectal cancer. The mortality rate of colorectal cancer in China ranks fourth in the mortality rate of malignant tumors, which shows that the incidence rate of colorectal cancer and its harm to health are very amazing! Therefore, it is particularly important to prevent and screen colorectal cancer as soon as possible and carry out "early diagnosis and early treatment".

2 The initiator behind colorectal cancer

After recognizing the "killer" of colorectal cancer, people will ask, what drives it to "make waves" The risk factors of colorectal cancer mainly include: eating habits, disease factors, family inheritance and age. Epidemiology shows that drinking, smoking, obesity and lack of exercise are potential risk factors for colorectal cancer.

0 1 eating habits

Unbalanced diet, high fat, high protein and low dietary fiber intake are closely related to the incidence of colorectal cancer. Dietary fiber can adsorb harmful substances in the intestine, which is beneficial to excrete them. Studies have shown that insoluble fiber is superior to soluble fiber in preventing colorectal cancer, and plant fiber is more effective than cereal and fruit fiber.

first part

Lack of vitamins

Studies have shown that vitamin A and retinol have protective effects on the occurrence and development of colorectal cancer, and the lack of vitamin D and folic acid can increase the risk of colorectal cancer.

Intestinal flora imbalance

In patients with colorectal cancer, the intestinal flora will be disordered. Supplementing probiotics can improve the structure of intestinal flora and affect intestinal metabolism, thus reducing the risk of colorectal cancer.

Nitrite compound

Nitrite compounds are the most famous carcinogens. As an edible colorant, it is widely found in pickled foods such as sausages and sufu, and its harm is self-evident and can induce various tumors.

02 disease factors

Ulcerative colitis, colorectal polyps, adenomas and other diseases are related to colorectal cancer. The canceration of colorectal cancer follows the path of "inflammation-proliferation-canceration", which takes at least 10 years. At present, adenomatous polyp, villous adenoma and familial polyp are considered as precancerous lesions of colorectal cancer.

Age and genetic factors

The incidence of colorectal cancer will increase with age, and the prone age group is concentrated in 40-70 years old, but this does not mean that young people can take it lightly. The malignant degree of young and middle-aged patients with colorectal cancer under 40 years old is generally high. The incidence of hereditary colorectal cancer accounts for 20% of the total incidence of colorectal cancer, among which hereditary nonpolyposis colorectal cancer is caused by the defect of DNA mismatch repair gene (MMR).

Shut up and open your legs, and be a smart "dry man"

In terms of diet, it is necessary to control the intake of high-fat and high-protein foods and carry out a high dietary fiber diet, especially to supplement vegetables and fruits; Pay attention to supplementing various vitamins, especially vitamin A, vitamin D and folic acid; At the same time, eat less or no leftovers, sausages and pickled foods; Research shows that moderate and high-intensity exercise every day can significantly reduce all-cause mortality! So, keep your mouth shut and open your legs, once again proving its status as a golden sentence for health preservation! In addition, diseases related to colorectal cancer should be treated promptly and effectively to prevent them from malignant transformation and developing into colorectal cancer.

4 early screening to cure the disease.

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The necessity of early screening

Polyp is a tissue vegetation that can be observed by gastrointestinal endoscopy and belongs to benign tumor. However, most colorectal cancers are evolved from colonic polyps, especially adenomatous polyps. It usually takes 7- 12 years to progress from adenomatous polyp to early cancer, but patients with adenomatous polyp and early colon cancer have no clinical manifestations, and most of them have advanced to the middle and late stage when they are diagnosed. Therefore, it is necessary to conduct early colorectal cancer screening. Studies have shown that regular screening for early colorectal cancer can reduce the incidence of colorectal cancer by 76%-90% and the mortality rate by 60%! Therefore, everyone must have the concept of "preventing disease". Regular physical examination can help us treat serious illness as soon as possible and turn it into a minor illness!

02

Screening objects and methods

Early screening of high-risk groups is extremely necessary. People who are 50-75 years old, have a family history of colon cancer, smoke and have a body mass index of 25 kg/m 2 are considered as high-risk groups of colorectal cancer!

Here are some detection methods (full of dry goods! ), colonoscopy is the gold standard of colorectal cancer, which can visualize the rectum and the whole colon, and can remove adenomatous polyp, thus preventing colorectal cancer, so it is recommended as the first choice for detection.

Screening scheme for general population

It is suggested that colonoscopy should be done directly every 5- 10 years. If the screening object is not satisfied, questionnaire risk assessment and fecal immunochemistry can be used for primary screening, and those who are positive for primary screening will be further tested for multi-target fecal DNA, and those who are above positive will be examined by colonoscopy.

Screening program for high-risk groups

A: For those with family history, it is recommended to have a 1 colonoscopy every five years from the age of 40.

B: Patients with adenomatous polypus syndrome and carriers of pathogenic mutations are advised to have 1 colonoscopy every year.

C: For family patients with hereditary nonpolyposis colorectal cancer (Lynch syndrome), it is recommended to have colonoscopy/kloc-0 once every two years at the age of 20-25, and/kloc-0 once every year after the age of 40.

5 Intestinal preparation before colonoscopy

Colonoscopy is the most effective screening method for colorectal cancer at present, and intestinal preparation is the key to colonoscopy, which directly affects the quality of colonoscopy. At present, compound polyethylene glycol electrolyte powder is widely used as intestinal cleaner in the world. Capsule endoscopy generally cooperates with compound polyethylene glycol electrolyte powder and simethicone to prepare the intestine before examination, which can clean the intestine, effectively remove bubbles in the intestinal cavity and make the colonoscopy results more accurate.

Administration method of compound polyethylene glycol electrolyte powder: dissolve the powder in water (1 l /2 l) and stir evenly. The dose of adult/kloc-0 per time is about 2-4 liters, which is taken orally at the rate of 1 liter every 1 hour, and the administration can be terminated when the discharged liquid becomes transparent; The total dose should not exceed 4 liters. Add simethicone emulsion and take it orally for the last time. (For details of medication, please refer to the colonoscopy reservation form. )

(1) Administration on the day of the examination: fasting breakfast (allowing drinking water) on that day, and administration about 4 hours before the scheduled examination time.

(2) Check the administration the day before yesterday: fasting (drinking water) after dinner the day before yesterday, and administration 1 hour after dinner. Eat less food for breakfast and lunch the day before yesterday, and eat liquid food instead of solid food for dinner.

Contraindications: patients with gastrointestinal obstruction and suspected intestinal obstruction, patients with intestinal perforation, patients with toxic enteritis and toxic Hirschsprung's disease are prohibited.

Early diagnosis and screening are important measures to reduce the incidence of colorectal cancer and improve the survival rate of patients with colorectal cancer. Compared with the fruitful secondary prevention work in developed countries, the screening of colorectal cancer in China began in the 1970s, but today, the five-year survival rate of patients with colorectal cancer is still far lower than that of the United States, Japan and South Korea, and the diagnosis rate of early colorectal cancer is also significantly lower than that of Japan and South Korea. In 20 12, China started the project of "early diagnosis and early treatment of urban cancer", but the proportion of people receiving colonoscopy was less than 14%. In terms of enhancing public awareness and participation, China's prevention work still has a long way to go.

Recently, the state has continuously introduced new policies to encourage hospitals at all levels to carry out early screening, prevention and control of cancer, and put forward the promotion of "early diagnosis and early treatment" of cancer.

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Text: Yang Yushan