Il colorectal cancer it does not concern only the elderly: also among the under 50Indeed, the number of cases is on the rise. There are some important ones alarm bells not to be underestimated that, if identified quickly, allow a early diagnosis and greater chances of recovery. Let’s find out the symptoms to watch out for.
THE ALARM BELLS
Diarrhea frequent and persistent blood loss (together with feces or not), abdominal pains continuous and persistent e anemia. These are the alarm bells identified by a group of scholars from the Washington University School of Medicine in St. Louis, who could help identify colorectal cancer early, increasing the chances of recovery. They are especially the under 50 for which screening is not envisaged, as is the case for subjects between 50 and 70 years of age, who should pay particular attention to these symptoms.
I STUDY
The study involved 5,075 patients with early-stage colorectal cancer. According to the results just published in the journal Journal of the National Cancer Institutethese four signs could allow you to track down a early cancer, even two years earlier than happens in most cases. In fact, almost half of the participants suffered from one or more of these disturbances at least three months before diagnosis.
NO PANIC
Symptoms such as abdominal pain, diarrhea, anemia and blood in the stool could also signal the presence of other less serious and more widespread pathologies, so it is good not to be excessively alarmed, but to know how to behave.
“In case of specific symptoms, such as those suggested by the study – explains the Doctor Marco SonciniNational President AIGO and director of the medical department at the ASST of Lecco – you shouldn’t panic, but be aware of the need to consult your doctor. In fact, in addition to alerting the population, it is essential to raise awareness among family doctors who must be able to refer patients to specialist visit necessary. The gastroenterologist then thanks to the appropriate tests, he will be able to arrive at a differential diagnosis, excluding other pathologies. Especially diarrhea and stomach ache, in fact, can be symptoms related to other less serious and non-oncological pathologies ».
SUBJECTS AT RISK
There are subjects at risk who should be constantly followed up by specialists.
«Among people under the age of fifty – recalls the Professor Renato Cannizzaro, University of Trieste and Director of SOC Oncological and Experimental Gastroenterology of the Oncological Reference Center of Aviano, – we know that there are groups of patients particularly exposed to the risk of developing colon cancer: the presence of Crohn’s disease e rettocolite ulcerosa which can also arise in childhood, or hereditary susceptibilities attributable to syndromes in which genetic mutations have been identified such as familial adenomatous polyposis (FAP) and the Lynch syndrome».
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CHECKS FOR THE OVER 50s
Il colon cancer– rectum and the second type of tumor more frequently in our country, and is also the second among the deadliest, with 48,100 new diagnoses estimated in 2022 and 21,700 deaths. There is an effective way to diagnose it early, but unfortunately in Italy it is very little used. We are talking about screening offered free of charge every two years to all people from the 50s and 70sto search for occult blood in the stool.
“In Italy less than 50% of the population in the 50-70 age group – explains Dr. Soncini – adheres to the screening for the colorectal cancer. In the most virtuous communities it reaches 40-45%, and only rarely does it exceed 50%. In the southern regions of the country, unfortunately, we are around 15-20%. The risk of diagnostic delay it is therefore very high. Following a positive fecal occult blood test, adherence to second level tests such as colonoscopy, fortunately, increases considerably, reaching about 85%”.
THE UNDER 50 AND THE DIAGNOSTIC DELAY
For subjects with less than 50 yearsi, on the other hand, to whom the biennial screening is not aimed, the risk of diagnostic delay is due precisely to the tendency to ignore the alarm bells which we talked about. Certain that the risk of colorectal cancer does not concern them given their young age, subjects affected by diarrhea, abdominal pain, blood in the stools or iron deficiency anemia, caused by iron deficiency, do not go to the doctor, and do not bother to proceed with further investigations. To increase the chances of early detection of colorectal cancer even among the under 50s, it could make sense lower the screening age (as was recently done in the United States which decided to offer screening from the age of 45)?
«For now, the primary objective is to increase adherence to the screenings of the subjects for whom they are foreseen, 50-70 year olds – explains Professor Cannizzaro – and to sensitize the under 50s to pay particular attention to the alarm bells we have spoken about, especially diarrhea persistent and iron deficiency anemia. Also there rapid weight loss and unexplained is among the alarm bells to pay attention to, as reported in the recommendations published in the journal Clinical Gastroenterology and Hepatology, on patients with early-onset colorectal cancer. Occult blood in the stool, on the other hand, in the younger range, could be due to other causes such as hemorrhoids, and abdominal pain is an extremely generic symptom. Reducing the age of access to screening is a major health policy commitment, but given theincrease in cases in young people we could be put in a position to anticipate screenings in Italy as well. What we are already trying to do, however, is bring out genetic syndromes underdiagnosed, such as the Lynch syndromewhich predispose to the onset of colorectal cancer.
USEFUL TIPS
I colorectal cancersin addition to familiarityrefer to the lifestyles. The main risk factors are represented by:
- excessive consumption of red meat, sausagesrefined flours and sugars
- overweight
- reduced physical activity
- smoke
- excess of alcohol
Protection factors instead they are represented by consumption of fruits and vegetables, unrefined carbohydrates, vitamin D and calciumand from the administration of non-steroidal anti-inflammatories for a long time. But beware of this last point: yesAlthough the data point to a protective effect of the drug, experts and regulatory authorities have maintained a great caution e do not recommend the use of aspirin to prevent colorectal cancer. Why? First, taking acetylsalicylic acid can be associated with important side effects, such as the risk of bleeding, which always require careful medical supervision to balance the risks and benefits on individuals. Furthermore, counterproductive effects of aspirin have emerged over time among cancer patients over 70 who took it to contain the risk of relapses.