This Tuesday (February 4) is World Cancer Day. There is a lot of good news in the cancer field. Two weeks ago, the Integraal Kankercentrum Nederland reported that the chances of survival have risen slightly. This applies, among other things, to colon cancer, where the population screening has proved to be a great success. To detect even more patients early, the Maag Lever Bowel Foundation (MLDS) wants to lower the age by five years.
For the past five years, every Dutch citizen has received a call for the bowel cancer population screening around the age of 55. The RIVM invites people over the age of 55 to return some faeces to check for colon cancer. Small blood traces are then searched in the laboratory. That may mean that there are cancer or polyps in the gut. Polyps can develop into colon cancer.
Greater chance of survival due to earlier detection
Professor of gastrointestinal oncology Evelien Dekker of the Amsterdam UMC was at the basis of the introduction of population screening in 2014. According to her, the program is very successful. Many people respond to the call. “With 72 percent, the Netherlands is the world leader. We are detecting colon cancer at an early stage.”
That is crucial, says Dekker, because the sooner colon cancer is discovered, the more chance of a cure and the less severe the treatment. In the long term, the population screening can prevent one in three deaths.
Time is ripe for earlier detection
In 2018, more than 14,000 people were diagnosed with colon cancer. 5,038 People died from the disease. That’s fourteen deaths a day. To be able to detect colon cancer at an even earlier stage, the Maag Lever Bowel Foundation (MLDS) wants to lower the screening age: from 55 to 50 years.
“With a reduction, we suspect 750 to 1,000 cases of colon cancer per year to be detected earlier.”
Bernique Tool, MLDS director
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MLDS director Bernique Tool: “With the reduction, we suspect that we can detect 750 to 1,000 cases of colon cancer a year earlier. That leads to a better chance of survival: starting stage one gives a chance of survival of 90 to 95 percent after five years . When the stage four, an advanced stage, is only started, it is around 11 percent. “
In line with the rest of Europe
The age reduction is in line with European guidelines. They prescribe screening from the age of fifty. The fact that the European directive was introduced five years ago was due to the fact that it was not clear at that time how many screenings the call would produce. There is now a view on that. Moreover, there is sufficient capacity in the colonoscopy centers to also screen the group of 50 to 55 year olds.
Another reason to lower the age limit: digestive cancers, including colon cancer, will only increase in the future. According to Tool, that is because we are getting older. “Lifestyle factors also play a role, for example the increase in obesity.”
Even better screening
According to Dekker, there are other ways to improve screening in addition to age reduction. The results of the stool test can be combined with other risk factors such as age, gender and the occurrence of family members with colon cancer.
“The sooner colon cancer is detected, the greater the chance of a cure.”
Evelien Dekker, professor of gastrointestinal oncology
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Dekker also conducts research into the detection of specific proteins from colon cancer in the stool. She does this together with Gerrit Meijer, head of pathology at the Antoni van Leeuwenhoek hospital. Detecting these proteins could possibly make the population screening even more accurate.
Dekker: “If we can detect proteins or DNA in the faeces that are specific to colon cancer, they may in the long term be able to very reliably predict whether there is colon cancer or polyps in the intestine. Perhaps even if a polyp will develop into cancer.”
Recognize complaints on time
By the way, don’t wait until you get a call for the population screening, say both Dekker and Tool. Be alert for complaints such as a changed stool pattern, blood in the stool or empty urge. Then go to the doctor. Dekker: “It does not have to be colon cancer, but if it is, it is better to be there as quickly as possible. The sooner colon cancer is detected, the more chance of a cure.”
World Cancer Day is on 4 February. Around that day, hospitals and open homes organize open house. Events are organized throughout the country for people who, in any way, have been confronted with cancer.
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