Colorectal cancer prevention plan

How is colorectal cancer caused?

It is caused by a growth in the large intestine known as a polyp. Some polyps can become cancerous, and therefore it is advisable to detect them early.

It's the most common type of cancer tumour, taking into account both men and women (it's the second most frequent among women, after breast cancer, and the third most common among men, after prostate cancer and lung cancer), and it is the second cause of death due to cancer. It is practically nonexistent before the age of 40-45, but becomes substantially more prevalent after the age of 60.

However, if it is detected in time, it is very easy to treat and is very likely to be cured. Symptoms are usually not present until the disease is advanced, so an early diagnosis is crucial when it comes to effectively detecting and removing precancerous lesions and preventing their development.
 

What is the symptomatology?

Depending on the location, the following symptoms may be present:
 

• Blood in faeces: this can be red, most often with tumours at the end of the colon, or black, which causes black stools known as 'melena', which tend to appear when the tumour is located at the start of the colon. A loss of blood can result in anaemia.

• Abdominal pain.

• Changes in bowel movements: diarrhoea, constipation or a combination of both.

• The feeling of an incomplete stool passage. Thinner stools caused by the constriction of the intestine.

• Other generic cancer symptoms: tiredness, weight loss for no apparent reason, etc. If any of these symptoms appear, you should see a doctor to assess the cause and, if necessary, receive the necessary treatment.

What does the early detection plan for colorectal cancer consist in?

The target is to implement a screening programme aimed at the medium-risk population (50-69 years) based on a faecal blood test every two years. If the test is positive, a colonoscopy is carried out to check for possible malignant or premalignant lesions.

Provinces are incorporated annually into the early detection plan for colorectal cancer by DKV until the set cover is reached. At the end of 2023, 23 provinces will have implemented the plan:

Who is this plan aimed at?

For all men and women between the 50 and 69 years of age.
 

How can I adhere to the plan?

If you are a DKV mutual society member, are in the age range between 50 and 69 and you live in the provinces where the campaign is going to be carried out this year, you will receive your invitation to participate by email. If we do not have your email, go to activate your card and provide us your contact details.

The process is very simple. You only have to accept the invitation and go to one of the reference centres to collect the test and instructions to conduct the test. If you do not have an email address, don't worry, you will receive your invitation by post.
 

What does the test consist in?

It consists in taking a simple and comfortable test every two years to detect if there are small quantities of blood within stools, which may not be visible to the naked eye. In most cases, colorectal cancer develops from small polyps that can bleed intermittently without causing any irritation.

Along with the invitation, a list of centres will be attached from where to collect the kit for detecting hidden blood in faeces and the instructions for conducting the test at home.

The test does not need to be taken on an empty stomach, nor does it require any kind of dietary change. Just avoid taking the test if you have bleeding haemorrhoids or are menstruating until three consecutive days have passed without loss of blood.

After collecting the sample, take it to the Espacio de Salud or the clinical analysis centre, from which it will be sent to the laboratory.

You will receive the result (by mail or by telephone) in a few weeks.
 

What can the result be?

If no blood is detected in the test, colorectal cancer is unlikely. After two years, you will be invited to join the programme again. However, if you experience any discomfort (bleeding, change in bowel habits, weight loss for no known reason), consult your doctor.

In five of each one hundred people appear indications of blood, almost always because of a benign injury, such as polyps and only in few cases as a result of the existence of a cancer.

To find out where the bleeding is coming from, you will be offered a colonoscopy, which explores the inside of the intestine, under sedation, with a low risk of complications. The colonoscopy leads to an early diagnosis or the extraction of a polyp, which, even if it is benign, could turn into a cancerous lesion.
 

How can I prevent the illness?

Prevention is based on eliminating or removing risk factors that increase the chances of suffering from the disease. Factors that can increase the chance of suffering from colorectal cancers are:

• A diet that is poor in fibre and animal fats (red meat).

• A lack of physical activity.

• Tobacco and alcohol consumption.

• The presence of inflammatory bowel disease (ulcerative colitis or Crohn's disease).

• Family history. In 5% of cases of colon cancer, genes are detected whereby their alteration leads to syndromes in which colorectal cancer is more likely to appear. The two most significant examples are familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer.

• Personal history of adenomatous polyps.

People with a high risk of intestinal diseases, or who have a family history of such due to genetic alterations, must monitor their situations closely to facilitate early diagnoses.

Anybody can prevent colorectal cancer by improving their health routines: increase fruit and vegetable consumption, limit the amount of animal fats consumed, avoid obesity, moderate alcohol consumption, do not smoke and ensure regular physical activity.
 

Useful links:

• AECC (Spanish Cancer Association): all about cancer.

• European Code Against Cancer (World Health Organisation). Twelve ways of reducing the risk of cancer.

• Spanish Cancer Association: colon cancer.

• Partnership for colon cancer prevention.