Colorectal cancer: don’t delay diagnosis
Almost one in ten cancers are classified as colorectal. Incidence is higher in developed countries and is rising as the population ages. Around 470,000 Europeans are diagnosed with the disease each year. In my country, Portugal, the disease kills close to 4,000 people annually.
However, in working with patients affected by the disease, I have learned that awareness of colorectal cancer – or bowel cancer – is low compared to other cancers.
This may be due to embarrassment of discussing colorectal health. However, the impact of delaying diagnosis is significant.
More than 90% of patient diagnosed with cancer in the wall of the colon (TNM sages I and II) will survive for more than five years. For those diagnosed later, in stages III and IV, the outcomes are much less encouraging. Around 50% of patients with stage III colon cancer will survive for more than five years. Only 10-20% of stage IV patients survive beyond five years.
As someone who has had difficult conversations with patients diagnosed with late-stage cancer, I can attest to the importance of early intervention. That is why I was happy to take part in a colorectal screening initiative in Portugal. This project has shown how testing stool samples for blood can help to raise awareness of the disease and, crucially, identify cancers early. Leaflets, a website, a Facebook page and SMS reminders were part of a multimedia approach to engaging with patients and encourage screening.
The Portuguese Colorectal Society found that the campaign made patients more alert to symptoms of the disease and more proactive about seeking medical attention. More than 5,000 text messages have been sent to patients, in addition to 5,000 emails sent. Visits to the website and Facebook page have exceeded expectations. On the website, the typical visitor spends more than four minutes reading material. This shows that they are engaged with the content and are keen to learn more about the disease.
To me, this is an essential and valuable part of my job. Early screening contributes to a decrease in the number of ostomised patients and deaths resulting from advanced stage detection. Furthermore, it identifies lesions earlier and thus allows a more effective treatment. This means that, as a society, we get better value for cancer medicines we use because they are more likely to be effective when used in the earliest stages of cancer.
I believe that this example shows that, with the support of doctor and nurses, health systems can begin a more open dialogue about colorectal cancer. There may be a reluctance to discuss cancer but we have a positive message to share with the public: get tested early and improve your outcome.
As a nurse, I am proud to have taken part in this campaign. Let’s hope we can continue to embrace screening initiatives which are proven to be effective – for patients, for health professionals and for the wider health system.