The high incidence of colorectal cancer is not only related to the improvement of life expectancy and medical diagnosis and treatment level in Shanghai, but also to the change of people’s lifestyle. Gao Jianping’s surging information
In the past 50 years, the incidence of colorectal cancer in Shanghai has increased more than five times, reaching 55-56/100,000 in 2013. There are as many as 8000 new cases of intestinal cancer in Shanghai’s permanent population every year.
Experts pointed out that in the past, the high incidence of colon cancer in Chinese was different from that in the west, and the common high incidence was rectal cancer and sigmoid colon cancer, but now the incidence of colon cancer has increased significantly. This is mainly related to the westernization of people’s life and diet structure.
On August 20th, reporter The Paper (www.thepaper.cn) learned from Shanghai International Medical Center that a multi-disciplinary (MDT) consultation platform across hospitals appeared in Shanghai, and the first disease that experts focused on was colorectal cancer, which was also the first comprehensive consultation platform project across multiple hospitals and disciplines in China.
Screening: 1.78 million retired people have a high risk of 340,000
Cai Sanjun, director of colorectal surgery at Fudan University Cancer Hospital and chief expert of multidisciplinary treatment group for colorectal cancer, revealed that epidemiological investigation found that the incidence of colorectal cancer in Shanghai increased more than five times in the past 50 years, from 87/100,000 in 1962 to 55-56/100,000 in 2013. Since 2003, colorectal cancer has jumped to the second place in the incidence of malignant tumors.
"At present, there are 8,000 new cases of colorectal cancer in Shanghai’s permanent population every year, and the incidence of colorectal cancer will rise in the future." Cai Sanjun said that the high incidence of colorectal cancer is not only related to the improvement of life expectancy and the level of medical diagnosis and treatment in Shanghainese, but also an important reason is the change of people’s lifestyle.
Zhang Jun, deputy director of the oncology department of Ruijin Hospital, also agreed. He revealed that in the past, the high incidence of colon cancer in Chinese was different from that in the west, and the common high incidence was rectal cancer and sigmoid colon cancer, but now the incidence of colon cancer has increased significantly. This is mainly related to the westernization of people’s life and diet structure.
An epidemiological report on cancer in Shanghai shows that the incidence of colon cancer has surpassed that of rectal cancer since 1991, and the gap is gradually widening. In 2011, the incidence of colon cancer accounted for 59.6% of colorectal cancer. The data shows that there are more than 10,000 patients with intestinal cancer in Shanghai municipal hospitals every year, including 3,000-4,000 patients from other places. It is estimated that the annual operation volume of intestinal cancer in Shanghai, including secondary hospitals, is between 12,000 and 13,000. "
According to Cai Sanjun, a project of "colorectal cancer screening for community residents" is being carried out in Shanghai, covering the permanent population who have reached retirement age and participated in various basic medical insurance and basic medical security in Shanghai. The plan is to complete the screening of 4 million people, but only 1.78 million people have been completed so far, mainly because the awareness of community residents’ participation is not strong. However, among the 1.78 million retired people who have been screened, there are 340,000 high-risk groups.
"It is reasonable that these 340,000 people should go for further examination of colonoscopy, but only 94,000 people have done it." Cai Sanjun said that among 94,000 people, 2,100 were diagnosed with intestinal cancer, 40% of them were still in the early stage, and after treatment, the 5-year survival rate could reach over 95%, while 18,000 people were found to have colorectal polyps, 60% to 70% of which may become cancerous when they grow up.
"I can imagine how many patients with early intestinal cancer will not be found in time in the rest of the population." Cai Sanjun appealed to the public to actively participate in and cooperate with this screening work.
Consultation platform: more than 30 top three experts participated.
Previously, the treatment of colorectal cancer was mainly focused on surgery, and no other disciplines were involved.
After 1990s, radiotherapy and chemotherapy proved their value in colorectal cancer. Liver metastasis and lung metastasis of colorectal cancer need the active participation of liver surgery and lung surgery. At the same time, in the field of medical diagnosis, imaging, endoscopy and other disciplines can provide the location, size and staging of tumors more accurately. This makes the determination of the correct diagnosis and treatment plan for colorectal cancer involve more and more departments. It is also on this basis that multidisciplinary diagnosis and treatment came into being.
However, in the multidisciplinary diagnosis and treatment carried out by traditional medical institutions, patients with incurable diseases often have to move from department to department, waiting in line repeatedly, and being exhausted. Complex diseases often merge with other problems, and doctors in each department can only give patients advice from their own fields. "Various departments are often’ railway police, each in charge of a section’ and’ treating the headache and treating the foot pain’, and the final treatment effect of patients is often greatly reduced." Zhang Wei, director of anorectal surgery at Changhai Hospital, said.
With the launch of the Multidisciplinary (MDT) consultation platform of Shanghai International Medical Center, it is a reality for patients with difficult colorectal cancer to get comprehensive consultation from experts in major hospitals in one stop.
"After the establishment of a cross-hospital multidisciplinary diagnosis and treatment platform, it is no longer the patients who are transferred between hospitals and departments, but our doctors. Therefore, on this diagnosis and treatment platform, everything starts from the diagnosis and treatment of patients and diseases." Yu Zhiqing, Dean of Shanghai International Medical Center, said that at present, this project platform has attracted more than 30 industry experts from Shanghai Cancer Hospital, Changhai Hospital, Ruijin Hospital, Renji Hospital and Longhua Hospital.
"These medical experts are well-known experts in the field of colorectal cancer diagnosis and treatment, and everyone is highly specialized in their own fields. Experts participate in this comprehensive consultation platform. On the one hand, they hope to work out the optimal treatment plan for patients with intractable diseases through cross-hospital cooperation. On the other hand, I also hope that in the interdisciplinary collision, experts can reach a better understanding and development. " Yu Zhiqing said.
According to the Shanghai International Medical Center, the MDT team of colorectal cancer in the medical center will give free consultation to 20 patients on August 21st, and select 5 difficult cases from them, and invite experts from all over the city for joint consultation. The first joint consultation of experts in the city is a public welfare project, with a quota of 5 people and no registration fee.
Zhang Jun said that at present, the UK law mandates that cancer diseases must be discussed through multiple disciplines. Comparative data abroad show that multidisciplinary diagnosis and treatment has obvious advantages compared with traditional diagnosis and treatment. "However, due to the large number of patients in China, it is unrealistic for all patients to undergo multidisciplinary comprehensive diagnosis and treatment. Therefore, at this stage, multidisciplinary comprehensive diagnosis and treatment is mainly for patients with incurable diseases and willing patients. At the same time, in order to ensure the actual effect of multidisciplinary comprehensive diagnosis and treatment, the number of patients open every week should not be too much. "