Καρκίνος του παχέος εντέρου: η νόσος του σύγχρονου τρόπου ζωής
Colorectal cancer: the disease of modern lifestyle
SubjectΈντερο, Παχύ -- Καρκίνος ; Cancer -- Research ; Colon (Anatomy) -- Cancer ; Καρκίνος -- Έρευνα
Colorectal cancer is a worldwide problem having increase in the number of cases and deaths globally, because of the expanding and ageing of the population in both developing and developed countries and the changes in our life habits. In 2008 approximately 1.23 million new cases of colorectal cancer have been reported worldwide, while colorectal cancer is the third most common type of cancer in men (663.000 new cases, 10% of all cancers) and the second most prevalent among women (570.000 new cases, 9.4% of all cancers). 600.000 deaths from colorectal cancer have been recorded in 2008 worldwide with more than half of the deaths in the developed countries (Globocan IARC 2008, Parkin et al 2002). Colorectal cancer deaths correspond to a percentage of 8% of cancer deaths worldwide, making it the fourth most common cause of death due to cancer. Colorectal cancer is ideal for screening since it evolves though a sequence of events that last long enough and lead from the normal epithelium to the development of adenoma and subsequently carcinoma. Early detection of the disease improves critically the survival rates. Major predisposing factors for the disease are the genetic factors, since there are recognized many hereditary syndromes, as wells as environmental factors and personal habits. There are various diagnostic tests for detection of the lesions, laboratory and imaging, with different characteristics, sensitivity, specificity and cost. The therapeutic approach depends on the disease stage and may include surgical removal, chemotherapy, radiotherapy or combinations of these methods. Screening methods can reduce significantly the incidence of the disease through early diagnosis and treatment of precancerous lesions, thus greatly reducing deaths from colorectal cancer. The countries with organized programs have the highest compliance of the population, while in countries with occasional and pilot screening programs the participation rates depend on the level of information and awareness among medical professionals and general public. In Greece all the available data indicate the need for an organized screening program, better information and education of the public, regarding the value of early diagnosis of the disease. Economic evaluation of the implementation of colorectal cancer screening proves that these programs are cost-effective, making screening for the disease neseccary for health systems, especially if we compare its cost with financial details of the treatment of disease. The more advanced the stage of diagnosis of the disease the higher the cost of treatment and the less the 5-year survival, making imperative the need for prevention and early detection through an organized screening program for the disease.