How Gastro Cancer Screening Can Help With Early Detection
According to the annual report in 2021 released by the Singapore Cancer Society, there were two primary awareness campaigns that Singapore conducted regarding gastrointestinal cancers. They were:
- Colorectal cancer: Also known as colon cancer, it is the most common gastrointestinal cancer in males and the second most diagnosed gastrointestinal cancer in females.
- Gastric cancer: Also known as stomach cancer, it is the seventh and ninth most diagnosed gastrointestinal cancer in males and females, respectively.
The issue with both cancers is that they do not display any obvious symptoms in the initial stages until it is too late. Hence, cancer screening is an opportunity for individuals displaying zero symptoms to get tested, especially if they have specific risk factors.
Cancer screenings are distinctively different from conducting gastroenterology tests when symptoms suggest cancer is present. The latter is regarded as a diagnosis of symptoms, not screening. In order for cancer screening to be effective, it must be conducted where early detection is possible, enabling successful intervention. Such stages could include pre-malignant or early malignant stages.
General screening procedures for gastrointestinal cancers
Before every screening procedure, your gastroenterologist will conduct a medical history as well as a detailed medical examination. After which, depending on the initial finding, your gastroenterologist may offer some of the following cancer screening procedures.
1. Blood tests and cancer markers
Any hints of organ dysfunction may be a possibility of a cancerous attack. For example, pancreas cancer symptoms include bile duct obstruction, which may show up as an abnormality during liver function tests. However, cancer markers are not the most reliable and specific due to the overlapping of cancer markers among cancers.
2. Imaging modalities
- Ultrasound examination: Ideal initial screening for pancreas, bile ducts, gallbladder, and liver cancers.
- Magnetic Resonance Imaging (MRI) scan: Enables visualisation of pancreatic and bile ducts.
- Computerised Tomography (CT) scan: It is useful in unique situations, especially during CT colonography, which is the 3D reconstruction of the colon to screen for colon cancer.
- X-rays: There are limitations to it being used for gastrointestinal cancer, but they are still being used.
3. Digestive endoscopy
Depending on where the possibility of cancerous cells developing is, some of the digestive endoscopies that might be conducted include:
- Endoscopic ultrasound: Using ultrasound imaging to scan the digestive walls for any masses.
- ERCP: Used to examine the pancreatic and bile ducts.
- Colonoscopy: Used to examine the entire colon.
- Sigmoidoscopy: Used to examine the left portion of the colon.
- Gastroscopy: used to examine the duodenum, stomach, and oesophagus.
4. Faecal occult blood test
If you are found to have large polyps or bleeding tumours, then a faecal immunochemical test might be conducted to screen for specific cancer.
Cancer screenings are effective in preventing colon and rectum cancer. Accurate and early detection of colorectal cancer and polyps can be achieved through regular screenings. You should conduct regular screenings for such cancers if you are aged over 50 years and older and have a family history of colorectal cancer, colon polyps, Familial Adenomatous Polyposis, Hereditary Non-Polyposis Colorectal Cancer, or chronic IBD.
As mentioned previously, an individual with colorectal cancer may not display any prior symptoms until it is too late. During such a late stage, colorectal cancer may display some of these symptoms, such as:
- Visible bloody stools
- Tenesmus, which refers to the painful need to clear the bowel, but minimal stools passed
- Anaemia which is present during screening
- Bloating due to colon obstruction
- Sudden weight loss
Individuals who suffer from either symptom should seek medical help immediately, even if they only surface at a later stage, as colorectal cancer is still treatable.
Stomach or gastric cancer
Stomach cancer is the fourth most common cancer in the world. However, it is the second most common cause of cancer-related death. Stomach cancer can be split into lower and upper stomach cancer. In fact, men are found to be more prone to developing stomach cancer.
Helicobacter pylori infection, which causes chronic gastritis, is found to be the leading cause of distal gastric cancer. Individuals who enjoy a high sodium diet, smoke, preserved foods, have Pernicious Anaemia, or have blood type A, are found to have a higher risk of developing gastric cancer. Other factors, such as suffering from reflux oesophagitis and hereditary polyp syndrome, can also increase the risk of developing gastric cancer.
Individuals above the age of 45 are recommended to go for a screening colonoscopy together with gastroscopy annually. The unfortunate thing about gastric cancer is that they do not display any symptoms in the early stage. Hence, the importance of annual screenings.
The risk of developing oesophageal cancer increases if the individual smokes, consumes an excessive amount of alcohol, and suffers long-term damage to the oesophagus due to the high temperature of drink and food intake. Some medical conditions, such as Scleroderma, Achalasia, and Tylosis, also increase the cancer risk.
In the lower oesophagus, adenocarcinomas, a type of cancer cell, can develop. The primary risk of developing such cancer cells stems from chronic reflux oesophagitis, causing the cells at the lower oesophagus to change to Barrett’s Oesophagus, which can become cancerous.
Primary liver cancer
Also known as hepatocellular carcinoma, it typically happens in the liver that is chronically scarred by liver cirrhosis and chronic hepatitis. The risk of developing liver cancer increases in males, especially those over 45 years of age or those with a family history.
Screening for primary liver cancer is typically not conducted as the yield is significantly low. However, those suffering from chronic liver disease are generally monitored. If they are diagnosed with liver cancer at an early stage, a liver transplant is usually conducted, removing both liver disease and cancer together.
Pancreatic cancer develops mostly in males over 65 years old who smoke heavily or have prior stomach resection. It can also occur from a scarred pancreas caused by chronic pancreatitis or precancerous tumours, such as cystic tumours or adenomas.
Screening for pancreatic cancer might not be the most effective. However, it is still recommended for individuals to conduct regular health screenings. Typically, an elevated pancreatic cancer marker, CA125, will lead to a thorough MRI or CT scan for the cancer.
There are no specific methods to prevent these gastrointestinal cancers except to make specific lifestyle changes to reduce your risk. Additionally, conducting regular health checkups with your gastroenterologist ensures that early detection of gastrointestinal cancers can be treated immediately. Here at GUTCARE, we provide a wide range of gastrointestinal treatments and solutions. Take charge of your gut health today.
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