A simple, fast, effective test: offered every two years to people aged 50 to 74 as part of organized screening for colorectal cancer, the faecal immunological test (FIT) is still not yet anchored in habits. The participation rate is only 33%, despite the proven value of screening: detected early, colorectal cancer – 3rd cause of cancer in men, 2nd in women – is cured 9 times out of 10! This is what doctors insist on the occasion of Blue March, the annual campaign to promote colorectal cancer screening.
In Draguignan, the Drs Catherine Cadot and André Mattéo, gastroenterologists, Jean-François Codoul, gastroenterologist and oncologist, and Caroline Teissier, general practitioner, got together for an event organized by all the healthcare players in the Dracenia (1).
Insufficient response rate
“The response rate to the screening campaign is clearly insufficient in France and this is even truer in the Var, with a response rate of around 28%, compared to 31% before the Covid period, far from the target rate of 45%”, regrets Dr. Cadot. A lack of adherence that is all the more damaging as the screening “not only makes it possible to identify cancers at an early stage which are easier to treat (in 90% of cases), but also to avoid them by detecting precancerous lesions (polyps) which can be eliminated”, completes Dr. Codoul. Excluding organized screening, only 21% of colorectal cancers are detected at a limited local stage, 24% at an advanced stage, 22% at a regional stage (lymph node) and 34% at an advanced stage (metastasized).
FIT or colonoscopy?
“In 4% of cases, the FIT is positive. It detects the presence of blood in the stool, which does not signify the presence of cancer. This test makes it possible to carry out a pre-selection for colonoscopy, examination who will validate or not the diagnosis of cancer”, summarizes Dr Matteo. The kit, given by the general practitioner, gastroenterologist, gynecologist or pharmacist, can also be ordered online. (2)
However, these screening methods only concern 80% of the population aged 50 to 74, classified as medium risk. For the 20% of patients said to be at high or very high risk of colorectal cancer – people with a personal or family history, or suffering from chronic inflammatory bowel disease or even certain genetic diseases – the French society of endoscopy recommends a colonoscopy from the outset and of course monitoring before the age of 50. Same procedure, regardless of age, for symptomatic patients presenting with rectal bleeding, transit disorders, abdominal pain, a palpable mass, anemia and/or a change in general condition: these must consult without delay.
Performed most often under general anesthesia, colonoscopy makes it possible to visualize the interior of the rectum, the colon (large intestine) and the end of the small intestine to identify the presence of any cancerous or precancerous lesions.
preventable cancer
“Thanks to these screening methods, colorectal cancer is a preventable cancer that almost no longer needs to exist. We should drastically reduce the number of new cases with better screening compliance, hammer the Dracénois doctors. We can and we must do better!” To finally dislodge colorectal cancer from the sad second place it occupies in the ranks of cancer deaths for all sexes combined.
1- Dracénie Provence Verdon Agglomeration represented by Dr Bonnabel, the Dracénie hospital center and the Notre Dame polyclinic.
2- https://monkit.depistage-colorectal.fr or on the website of the Regional Cancer Screening Coordination Center (CRCDC): https://depistage-cancers-sud.org/