The liver, stomach, and colorectal are three digestive organs that often have cancer, but tests or endoscopy can detect it early to increase treatment effectiveness.
“Gastrointestinal cancer is common and dangerous but can be completely cured and prevented if screened early,” said Dr. Nguyen Vinh Tuong, medical director of Victoria Healthcare clinic, at a discussion organized by the Club. Organized by the Saigon Businessmen Ministry, November 8.
The International Agency for Research on Cancer (Globocan) estimates that each year Vietnam has more than 180,000 new cases and more than 120,000 people die from cancer. In both sexes, the top 5 types of cancer are breast, liver, lung, stomach and rectum, increasing each year. In 2022, the cancer incidence rate in Vietnam ranks 90th out of 185 countries, but the mortality rate ranks 50th and is increasing on the global rankings. The reason is believed to be that many people are diagnosed with the disease at a late stage, so mortality is high.
Doctor Nguyen Vinh Tuong shared at the discussion. Image: Tam An
According to Dr. Tuong, each current screening method has its own advantages and disadvantages. In there, blood test for cancer markers (tumor marker), genetic testing is easy to perform, screening for many cancers at the same time, but the reliability is not high. If there are abnormal results, it must be screened with other methods to find cancer.
Currently, blood tests for cancer markers are often used when there are suspected lesions or to monitor cancer recurrence. Cancer screening in healthy people is not recommended because of poor sensitivity and specificity. This can easily cause anxiety, leading to many unnecessary follow-up tests, or making the patient confident when the results are normal, skipping the tests according to instructions.
The second means is diagnostic imaging such as X-ray, ultrasound, CT, MRI, PET CT, help accurately diagnose and assess whether the damage has developed or invaded other organs, but are expensive, depend on the doctor performing it, and do not require treatment. be hurt.
Tuesday, endoscopy helps to accurately diagnose, take tissue samples for cytology, and treat lesions by removing polyps, but this is an invasive method, dependent on performing skills, and expensive.
Liver cancer screening
It is necessary to detect and manage hepatitis B and C early, if present, to avoid leading to cirrhosis. Good treatment for alcoholic hepatitis and fatty hepatitis. High-risk cases require liver ultrasound and AFP testing every 6 months. If suspicion is detected, liver CT with contrast and biopsy should be performed.
Stomach cancer screening
Early prevention of stomach cancer by screening for HP bacteria through gastric endoscopy, biopsy or breath test, blood test (this method is simple but not completely accurate). If positive, need HP treatment for 2 weeks, check after treatment. Patients need to understand how this bacteria is transmitted to avoid reinfection in daily activities and eating. People with gastric intestinal metaplasia need complete HP treatment, endoscopic examination every 3 years, multiple biopsies during endoscopy, and use of a machine with NBI.
Endoscopy helps effectively screen for gastrointestinal cancer. Image: Clinic provided
Colon cancer screening
Screening can be done with a fecal occult blood test. This method is low cost and easy to do, but must be done every year. If positive, colonoscopy is required. Many false positive cases are due to eating foods containing iron.
The second means is virtual CT colonography (virtual colonoscopy), which can replace colonoscopy when patients are afraid of colonoscopy. However, this technique requires X-rays, if there is damage, endoscopy must be done to confirm, bowel preparation is required, and the cost is high.
Colonoscopy is the preferred method recommended by doctors today, helping to see early-stage lesions, allowing polyps to be removed and treated before the risk of cancer. The cost of this technique is often high, depending on the skill of the doctor performing it.
High-risk groups such as families with colon cancer, colon polyps, or ulcerative colitis should be screened for colonoscopy starting at age 40, within 10 years of the family member having colon cancer. , or according to the manifestation of ulcerative colitis. If screening does not show polyps, do it periodically every 5 years.
People at low risk, without warning symptoms, should be screened with colonoscopy from age 45. If screening does not show polyps, periodically every 10 years.
If there are polyps, the doctor will classify the polyps as hyperplastic (no risk of cancer) or adenomatous polyps (with a risk of developing cancer later). Patients are evaluated for biopsy results and polyp size, and the time for repeat endoscopy can range from 6 months to one or 3 years.