Colon cancer preventible with diet and early detection
But only 31% of people aged 50 to 74 who are not at higher risk for the tumor went for occult blood tests.
By JUDY SIEGEL-ITZKOVICH
While the number of people aged 50 to 74 who underwent a test for occult blood in the stool increased to 336,000 last year, about 30 percent to 40% of those with a positive result did not go for a colonoscopy. As a result, colon cancer was diagnosed at a less-treatable stage in about 70 of them.
At its annual press conference announcing March as National Colon Cancer Awareness Month on Wednesday, the Israel Cancer Association (ICA) urged everyone within that age bracket to undergo an annual occult blood test prescribed by their family doctors and to go on to an invasive colonoscopy scan if blood were found. People with a higher risk of colon cancer - the second-most common type of cancer in Israel - because they have had colon cancer before or a family history of the disease should go for a colonoscopy after being referred by their doctor. About 85,000 colonoscopy procedures were performed in 2008.
Although the National Colon Cancer Detection Program that began four years ago in cooperation with the health funds has increased the number of occult blood tests for precancerous lesions, over 3,181 new patients were added last year to the list of colon cancer victims.
Colon cancer is a preventible disease, and those who nevertheless develop precancerous lesions can raise their survival rate to over 90%. Early detection of precancerous polyps and their removal during colonoscopy can prevent them from becoming malignant. Some 400 Israelis were saved last year by early detection.
But only 31% of people aged 50 to 74 who are not at higher risk for the tumor went for occult blood tests, the ministry said.
According to ICA director-general Miri Ziv, people can change their lifestyles and eating habits to further reduce the risk of colon cancer. Ziv called on the ministry and the health funds to increase their efforts to carry out the national program, and on the public to exercise and minimize consumption of red meat. The risk can also be reduced significantly by eating more fruits and vegetables - especially green, leafy ones and cruciferous vegetables such as broccoli, spinach and cauliflower. Following a Mediterranean diet rich in fruits and vegetables is a good way to reduce colon cancer risk.
Eating poultry is highly preferable to eating red meat if you are not a vegetarian, experts say. Eating white-colored "meats" such as poultry and fish, which have much less heme-type iron, reduces the risk of colon cancer among non-vegetarians, according to research. Chlorophyll, which makes vegetables green, apparently helps neutralize the heme. Fruits and vegetables of a variety of colors contain carotenoids, which also help protect against colon cancer.
If you "have" to eat red meat despite the risks, Dr. Niba Shapira - an ICA adviser and a leading Tel Aviv University clinical dietitian - advises minimizing the amount and combining it with vegetables and fruits in the same meal to reduce the carcinogenic effects.
Eating factory-processed red meat is even more dangerous than eating unprocessed meat.
Meanwhile, a "significant breakthrough" in the fight against colon cancer is a study being conducted at Tel Aviv's Sourasky Medical Center, where researchers have identified a protein found on the surface of the cell that is a biomarker for many cancerous processes, including those of the colon. Four hundred samples of tissue removed from patients with malignant colon cancer and precancerous polyps were tested; the protein was expressed in about 90% of the tumors.
The research, headed by Prof. Nadir Arber and Dr. Sarah Kraus, resulted in their development of a simple and innovative experimental blood test based on expression of the protein in white blood cells. The test boasts 80% accuracy. Arber hopes to conclude the research within a year, and says that if experiments continue to show such results, the blood test will become routine and help identify those patients who are not aware that they are at higher risk for colon cancer.
A study carried out among nearly 48,000 men found that those who ate beef or lamb five times or more per week were 3.5 times more likely to get colon cancer than those who ate meat once a month or less. This is because the red-colored molecule called heme, which carries iron in the blood, has been proven to have the potential to spur the growth of colon cells and their tendency to become cancerous.
A follow-up study conducted in The Netherlands on 121,000 people aged 55 to 69 found 1,535 cases of colon cancer over a period of 9.3 years. It also found that the more red meat was consumed, the higher the risk of colon cancer in both men and women.
During awareness month, the ICA will promote a campaign including the newspapers, the electronic media and the Internet. By calling a free phone number - 1-800-599-995 - people will be able to order an up-to-date booklet on prevention and early detection of colon cancer.
Anat Flochsman, a 49-year-old married mother of three who works as a theater actress and director and was diagnosed with colon cancer 10 months ago, said it was her "stubbornness" that led to its detection. Her family doctor, she said, belittled the abdominal pain she had been feeling for some time and declared that she "had nothing dangerous." She finally managed to get his referral to a gastroenterologist, who sent her for a colonoscopy that discovered the disease.
During a series of chemotherapy sessions, she came up with the idea of showing a video presentation and works of art she had designed that expressed her feelings about struggling with colon cancer. She has presented it in a hospital before fellow colon cancer patients.
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