Gastrointestinal Cancer Screening

Gastrointestinal Cancer Screening at the right time can be a life saving procedure.

The gastrointestinal tract runs from the mouth to the anus, and includes the oesophagus (gullet), stomach, small bowel or intestine, and the large bowel (colon and rectum). Cancer can affect any part of the gastrointestinal tract, although, curiously, it is rare in the small intestine where most digestion takes place.

Some of the common types of cancer that can affect you include;

• Bowel cancer (colorectal),
• Stomach cancer,
• Cancer of the pancreas,
• Oesophageal cancer, and
• Cancer that develops first in the liver (primary liver cancer).

Gastrointestinal Cancer Screening is the process of checking people who have no symptoms for Gastrointestinal Cancer, which can then be treated more successfully than if the disease had been left until it showed itself.

Screening has been proposed for gastrointestinal cancers. Each cancer needs to be considered separately but any screening programme should have certain common properties that are essential for success:

• The disease should be fairly common in the population or group of people that is considered to need screening (otherwise the benefit to any one individual will not be sufficient to counterbalance the risk and inconvenience of screening to the rest),
• A diagnostic test to detect the condition is needed that is simple, cheap and reliable,
• Effective treatment should exist.

When do you need Gastrointestinal Cancer Screening?

Screening tests are more likely to find disease in individuals who are at higher risk of the disease than the general population. So, screening of high-risk individuals will improve the overall benefit from a screening test. Two groups are generally considered to need screening:

• Individuals who have a first-degree relative (a parent, brother, sister or child) who developed colorectal cancer before the age of 45, whose risk of developing colorectal cancer in their lifetime is 1 in 10.
• Individuals who have two (or more) first-degree relatives with colorectal cancer, who have at least a one in six life-time risk.

What are the Risks in Gastrointestinal Cancer Screening?

There are no known risks in gastrointestinal cancer screening other than the fear of knowing one's condition.

There has been debate on the better form of cancer control. Should one be more concerned with screening or prevention?

Each gastrointestinal cancer has a different screening test and, even for colorectal cancer, the potential for increased survival in the average individual who undergoes screening is not very great.

An alternative strategy for the general population is to adopt a preventative measure that might simultaneously reduce risk of death from several conditions.

Measures could include lifestyle changes such as high vegetable, low-fat, diets and exercise regimens that are likely to simultaneously reduce risk of death from colorectal cancer and ischaemic heart disease (coronary artery disease).

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