When we talk about colon cancer prevention, colonoscopy is the gold standard that saves lives. When is it necessary, why is it good to monitor ourselves… Dr. Desislava Dimitrova, gastroenterologist from the “Saint Caridad” Hospital, speaks in front of FACT.
- Dr. Dimitrova, colon cancer - this is a serious diagnosis. But do Bulgarians, in general, have the health hygiene to take care of themselves prophylactically, and not go to the doctor when we have a problem?
- These are important topics such as colon cancer, screening, equal culture. For me, it is important to draw people's attention to the need for prevention, a healthy lifestyle, and improving health culture in general. My personal impression is that in Bulgaria, many people still go to the doctor when they have symptoms, i.e. the time for prevention has been missed. There are also more and more representatives of the other group, namely Bulgarians, who have an increasingly high health culture and are responsible for their health. It is precisely prevention that is the key to early detection of diseases such as colon cancer and allows for their complete cure and recovery of the patient.
- Colonoscopy is more than a test, but why are people afraid to undergo this test. How do you convince them that it is good to examine their gastrointestinal tract?
- A significant number of people have prejudices when it comes to colonoscopy - fear of pain, discomfort, even shame. The truth is that modern colonoscopy is performed under short intravenous anesthesia (anesthesia) and the patient feels neither pain nor discomfort and has no memory of the procedure. With an experienced endoscopist, it lasts a short time - a few minutes. Colonoscopy is the "gold standard" for diagnosis, and sometimes it can also be a therapeutic procedure - for example, when removing colon polyps. When the patient is calmly, clearly and adequately explained the advantages of this examination, its importance is clarified and concerns about the risks are reduced, persuasion is not necessary.
- Is the word colon prevention adequate in Bulgaria? We hear about campaigns, about the "silent killer" - as they call colon cancer, but Bulgarians go to the doctor only in extreme cases. Why is that?
- Yes, the concept exists, but the culture of screening in Bulgaria is still not at a high enough level. Unlike us in Western European countries, for example,
in countries like Germany and France, after 50 years of age, colonoscopy is a mandatory examination.
Even recently, recommendations are for an earlier start of screening – at the age of about 45. In our country, people often avoid preventive examinations. In addition, colonoscopy at this stage is not a mandatory examination in the preventive panel. There are still myths about it, regarding pain, complications, etc. I hope that our health culture will continue to improve in the future.
- What does a colonoscopy show a doctor?
- Colonoscopy is the “gold standard“ in gastroenterology for colon diagnostics. It allows not only diagnostics, but also prevention, and in some cases, treatment. During the procedure, polyps can be detected and removed – benign formations that can eventually turn into cancer, biopsies should be taken if there is a suspicion of inflammatory or other bowel disease. This is the surest way to prevent the development of colorectal cancer.
- Colon cancer develops slowly, over years. Without symptoms. After how many years is it good for a person to be examined, even if there are no symptoms?
- It is recommended to start screening colonoscopies at around 45 years of age. In case of a family history, i.e. the presence of a close relative with colon cancer, it is good to have the first examination 10 years earlier than the age at which the loved one was diagnosed. If the colon was “clean“, a repeat examination is recommended every 3 to 5 years, and over 75 years of age – every 10 years.
- What is the family history of colon cancer?
- It is one of the most significant risk factors. If a close relative has had colon cancer or polyps, the chance of developing the disease is higher and control should begin earlier. In such cases, prevention is absolutely mandatory.
- Why are there increasing cases of colon cancer in younger and younger people! How do you explain it?
- It would be difficult to give a clear answer to this question. The reasons are complex - diet (low in fiber and high in processed foods), sedentary lifestyle, obesity, smoking and alcohol. In addition, today the diagnostic capabilities are better, which leads to more cases being identified. But the trend is worrying.
- What are the symptoms that should make us consult a doctor?
- There are so-called “alarming“ symptoms, in the presence of which it is mandatory to consult a specialist:
-- blood in the stool
-- change in the rhythm of defecation – persistent constipation or diarrhea
-- bloating, abdominal pain
-- unexplained weight loss
-- anemia or constant fatigue
- What do polyps in the colon indicate?
- Polyps are benign growths, but they are where colon cancer often starts. The good news is that if they are detected and removed in time during a colonoscopy, the risk of developing cancer is significantly reduced.