The importance of screening

It is a common gastrointestinal disease, and early detection and timely treatment can effectively reduce the risk of colorectal cancer. According to the Hong Kong Health Bureau, colorectal cancer is the second most common cancer in Hong Kong, with more than 5,000 new cases each year. Colorectal polyps usually have no obvious symptoms in the early stages, but over time, some polyps can develop into cancer. Therefore, routine screening has become an important measure to prevent colorectal cancer.

The importance of early detection of colorectal polyps is that they can be removed before they become cancerous, thus avoiding the occurrence of cancer. Studies have shown that polyps typically take 10-15 years to develop into cancer, providing a valuable time frame for screening. Regular screening can not only detect polyps early, but also monitor their changes and take timely treatment measures.

Why do I need regular screening? Because the occurrence of colorectal polyps is related to various factors such as age, eating habits, and family history. The incidence of polyps increases significantly with age. The Hong Kong Cancer Foundation recommends that people over 50 years of age, especially in high-risk groups such as those with a family history or long-term inflammatory bowel disease (IBD), undergo regular screening for colorectal polyps.大腸瘜肉

Common screening methods

Currently, the main screening methods for colorectal polyps are:

• Fecal occult blood test (FIT): It is a non-invasive test that detects the presence or absence of colon polyps or cancer by detecting occult blood in the stool. Convenience and low cost are advantages, making it suitable for large-scale screening. However, it has the disadvantage of being less accurate and can result in false negatives or false positive results.
• Colorectal endoscopy: This is currently the most accurate screening method, which allows you to directly observe the condition of the lining of the large intestine and remove polyps as soon as they are found. Colonoscopy is highly accurate but invasive, requires preparation for bowel cleansing, and carries certain risks.
• Sigmoidoscopy: This test only looks at the lower part of the large intestine and has a limited scope, making it suitable for initial screening. But in the upper part of the colon polyp, it may not be detected.
• 電腦斷層結腸攝影 (CT Colonography): It is a non-invasive imaging test that reconstructs images of the large intestine with a CT scan. The advantage is that there is no need to insert an endoscope, but if abnormalities are found, a colonoscopy is required.

Timing and frequency of screening

According to the recommendations of the Hong Kong Ministry of Health, the timing and frequency of screening for different risk groups are as follows:

Interpretation of screening results should be done by a professional physician. If the FIT result is positive, further colonoscopy should be performed to confirm the presence of colorectal polyps or cancer. Polyps found during colonoscopy will be assessed for risk based on size, number, and pathology report, and a follow-up plan will be developed.

Tracking and treatment

Treatment for colorectal polyps depends primarily on the nature and size of the polyps.

• Colonoscopic polyp removal: In the case of small polyps, they can usually be removed directly during colonoscopy without additional surgery. It is currently the most common treatment, with less trauma and faster recovery.
• Surgical resection: If the polyp or cancerous tissue is large, surgery may be required to remove part of the intestine. Close monitoring is necessary after surgery to prevent recurrence.

The follow-up interval depends on the level of risk of polyps.

• Low risk (1-2 small adenomas): Return after 5 years.
• Intermediate risk (3-10 adenomas or 1 adenoma >1 cm): re-examination after 3 years.
• High risk (10 or more adenomas or high-grade dysplasia): re-examination after 1 year.

Preparation and precautions before screening

Preparation before colonoscopy is very important and directly affects the accuracy of the examination.

• Preparation for cleansing the intestines: A low-residue diet should be carried out 1-2 days before the test, and laxatives should be taken to empty the intestines. Incomplete bowel cleansing can lead to missed polyps.
• Dietary restrictions: Avoid high-fiber foods such as vegetables, fruits, and whole grains from 24 hours before the test.
• Medication adjustment: If you are taking anticoagulants (such as aspirin), you should discuss with your doctor beforehand whether you need to pause.

Possible risks and complications include:

• Intestinal perforation: rare but serious and requires immediate management.
• Bleeding: After polyp removal, there is slight bleeding that usually stops on its own.
• Risks of anesthesia: Some patients may be allergic to anesthetics.

Regular screening, early detection, active treatment, health protection

Screening and tracking of colorectal polyps is key to prevention According to data from Hong Kong, routine screening can reduce colorectal cancer mortality by more than 30%. Both the general and high-risk groups should undergo regular examinations according to the doctor's recommendations. Early detection and timely treatment of colorectal polyps can effectively block the cancer process and protect intestinal health.

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