HEALTH: Colon cancer, get screened!

Dr Jean-Baptiste Méric Oncologist and Director of the Public Health Division

Detecting this cancer is now easier thanks to the immunological test. This one, fast and effective, is to be done at home. It is aimed at women and men aged 50 to 74, invited every two years to discuss colorectal cancer screening with their doctor. The latter checks whether his patient does not present any particular risk requiring appropriate follow-up, then gives him the screening test to be carried out – all at once – at home. Our expert explains why this screening is essential.

France Dimanche: Why is it so important to take advantage of the month of March to get tested?

Dr Jean-Baptiste Méric: The month of March has been dedicated to promoting colorectal cancer screening for several years. Today, only 30% of people concerned (those between the ages of 50 and 74) take the immunological test every two years.

That is to say that there are only 5.5 million people who do it out of a target population of 18 million! The objective is to reach 45%. Some countries in Europe are better: for example Portugal with 63% or the Netherlands with 72%… In France, unfortunately, people are not involved enough.

FD: That is to say?

JBM: Organized screening for colorectal cancer has existed since 2009 and, in thirteen years, we see that the rate of this screening has stagnated. There are a lot of misconceptions about this. Most people say to themselves, “It’s not for me! However, this colorectal cancer does not have a bad prognosis: if it is caught in time, there is a 90% chance of survival, whereas if it is discovered at a late stage, there is only 15% chances of survival at five years… People have no idea of the importance of the benefit of this test! Sometimes they are also afraid of the outcome and, like the ostrich, bury their heads in the sand and prefer to remain ignorant. It is also true that the logistics put in place so far are an obstacle to screening: you have to make an appointment with your GP so that he can give you the test for free… Too often, you don’t consult your doctor for that or we do not think to ask him for the kit.

Testing kit

FD: What does this kit consist of?

JBM: It is designed to be simple and practical. With a small plastic brush, we collect a fraction of the stool and put this brush in a tube provided for this purpose. Then just fill in the form and send everything by post in the envelope provided. This residue will be processed by an analysis laboratory which will transmit the results to the attending physician. And it is he who will alert you if something happens.

FD: What is the slogan of this awareness campaign?

JBM: This means that if you are between 50 and 74 years old, you are concerned by this test which is capable of saving your life! Everyone hears about cancer and it can be scary. But today, we have effective tools to prevent it from developing in our intestines. This first test makes it possible to find out if you have blood in the stool, sometimes even at infinitesimal doses. In the vast majority of cases, the test will be negative and you will be reassured. And if you have a little blood, it may be a sign that you have precancerous polyps that can be removed during a second examination (colonoscopy), which will be an opportunity to explore your digestive tract. If a cancer is discovered, it can be cured with a minimum of treatment (a minor surgery, while avoiding chemotherapy), because it will have been detected early.

FD: Why do we need this test to know if we have this cancer?

JBM: This cancer affects an internal organ. You can’t see it, you can’t feel it, and you’re a little helpless because, at first, the patients don’t have any symptoms. Know that to go from a very small polyp to a precancerous polyp, it takes five years. And then, to pass from this polyp to identified colorectal cancer, it takes another five years… Hence the major interest in doing this screening early!

FD: What can be done to facilitate this screening?

JBM: As part of the experiments, the screening coordination centers in three pilot regions will send screening kits to the homes of the people concerned. Later this year, it will now also be possible to order this free kit online. Finally, third point, individuals of age to be screened will be able to retrieve the kit from their pharmacy, which will save them from having to go specifically to their general practitioner to ask for it.

A test every two years

Ludivine, 57, Paris Today, the immunological test is much easier to do. Yesterday, it was necessary to take three successive samples over three consecutive days, whereas with the new test put into circulation, just one sample is enough. I don’t even have to make an appointment with my GP, I just have to call his secretary to have the test made available to me at the doctor’s office! »

The association of tobacco with alcohol increases the risk of developing colon cancer by more than 8 times.

FD: What are the great enemies of this cancer?

JBM: Tobacco increases the risk of developing colorectal cancer by 2 to 3 times. Tobacco associated with alcohol, more than 8 times. The dietary advice I can give is that you should eat less than 500 grams of red meat and less than 150 grams of cold cuts (ham, sausage) per week. However, the French are mostly above these figures! It is estimated that, each year, 5,600 colorectal cancers are attributable to this overconsumption. This is not negligible out of a total number of cases of 43,000 per year…

FD: What are the physical signs telling us that things are not going well with the colon and rectum?

JBM: The presence of blood in the stool, transit disorders, unexplained abdominal pain for several weeks, sudden weight loss, these are the main signs of the disease. In these cases, it is absolutely necessary to consult. And above all, we must remember again and again that, to act with the best chance of recovery, we must intervene when there are no signs yet!