World Cancer Day: learn about high-risk groups, early screening and new treatments for some common cancers
How to screen and prevent different cancers as soon as possible? Cancer patients should follow cancer prevention advice after treatment. ◉ colorectal cancer general risk population at the age of 50-75 years old for colorectal cancer early screening, if there are colorectal cancer alarm symptoms (hematochezia, mucous and bloody stool, change of defecation habit, unexplained anemia, weight loss, etc.); for high-risk groups, colonoscopy is recommended for the first screening, and tumor markers and / or genetic tests are recommended if necessary. First-degree relatives or second-degree relatives have diagnosed colorectal cancer tumors or occurred colorectal polyps; finding a more suitable individual treatment for each patient can greatly improve the effective rate of treatment and prolong the survival time of colorectal cancer patients. ◉ lung cancer general risk people over 35 years old had better be screened every year, and the recommended means of lung cancer screening in China is low-dose spiral CT.
February 4th is World Cancer Day. In China, there are more than 3.5 million new cancer cases and more than 2 million deaths every year. Shi Yuankai, director of the China Cancer Foundation and vice president of the Cancer Hospital of the Chinese Academy of Medical Sciences, has pointed out that learning and understanding information on cancer prevention and treatment and achieving early prevention, early diagnosis and early treatment will help prevent cancer and reduce cancer hazards. How to screen and prevent different cancers as soon as possible? Which groups should pay more attention to? Which new tumor treatments are worth paying attention to?
With regard to cancer prevention, the World Cancer Fund and the China Cancer Fund have jointly put forward 12 cancer prevention recommendations, which are: quit smoking and limit alcohol; maintain a good mindset; be as thin as possible within a normal body weight; engage in physical activity for at least 30 minutes a day; avoid sugary drinks; eat more vegetables, fruits, whole grains and beans; limit red meat intake and avoid processed meat products No more than two servings of alcohol per day for men and no more than one serving for women (10-15 grams of alcohol per serving); restrictions on salted foods or foods processed with salt; no dietary supplements to prevent cancer; mothers should breastfeed their babies exclusively for six months; cancer patients should follow cancer prevention advice after treatment.
In addition, with regard to the early screening and new treatments for some common cancers, the Beijing News reporter sorted out the following contents.
◉ colorectal cancer
The general risk population is 50-75 years old for colorectal cancer early screening, any age, such as colorectal cancer alarm symptoms (hematochezia, mucous bloody stool, change of defecation habits, unexplained anemia, weight loss, etc.) is recommended; recommended once a year fecal occult blood test, or once every 1-3 years fecal multi-target FIT-DNA test, if the result is positive, further colonoscopy Colonoscopy was performed every 5-10 years.
For high-risk groups, colonoscopy is recommended for the first screening, and tumor markers and / or genetic tests can be performed if necessary.
High-risk groups: first-degree relatives or second-degree relatives have been diagnosed with colorectal cancer or intestinal polyps; suffer from familial adenomatous polyposis, Lynch syndrome, intestinal inflammatory diseases, such as ulcerative colitis, Crohn's disease and so on.
New therapy: molecular targeted drug therapy. Shen Lin, vice president of the School of Clinical Oncology of Peking University (Beijing Cancer Hospital), has introduced that determining the gene type of patients through Kras detection to find a more suitable individual treatment for each patient, chemotherapy combined with molecular targeted drugs such as siliximab can greatly improve the effective rate of treatment and prolong the survival time of patients with colorectal cancer, and even make a considerable proportion of unresectable patients resectable. To get the possibility of a cure.
◉ lung cancer
General risk people over the age of 35 had better be screened every year, at least 40 years old to start annual screening. The recommended method for screening lung cancer in China is low-dose spiral CT.
High-risk groups should be screened by low-dose spiral CT once a year.
High-risk groups: people aged 50-74 are at high risk of lung cancer if they have one of the following conditions. Smoking up to 30 packets of years (for example, 1 pack of cigarettes a day for 30 years or 2 packs of cigarettes a day for 15 years, that is, 30 packets of years); passive smoking for more than 20 years (i.e. office or family smoking, passive smokers work and live); history of chronic obstructive pulmonary disease; history of lung cancer in first-degree relatives; history of special occupational exposure.
New therapy: targeted therapy. On January 11, 2023, the State Drug Administration of China formally approved mobosetinib succinate capsule (Chinese name: an Wei Li) for adult patients with EGFR exon 20 insertion mutation in non-small cell lung cancer (NSCLC). This is the first targeted therapy for EGFR exon 20 insertion mutation in domestic lung cancer patients.
◉ breast cancer
Breast screening should be performed in the general risk population aged 45-70, and breast ultrasound examination should be performed every 1-2 years.
High-risk groups should be screened from the age of 40, and breast ultrasound combined with mammography should be performed once a year; for those who are detected as BKCAI/2 mutation carriers, breast ultrasound combined with mammography and breast nuclear magnetic resonance examination should be used.
High risk groups for breast cancer: women with family history of breast cancer; women with early menstruation or late menopause (menarche earlier than 12 years and menopause later than 55 years); patients with previous breast ductal or lobular atypical hyperplasia or lobular carcinoma in situ; patients who have received chest radiotherapy in the past; hormone replacement therapy with "estrogen" for not less than half a year; hormone replacement therapy with estrogen only for not less than half a year Breast X-ray examination after 45 years old showed that the type of breast parenchyma (or breast density) was inhomogeneous or dense. No history of lactation or lactation time less than 4 months; no history of live birth (including never giving birth, abortion, stillbirth) or the age of the first live birth is not less than 30 years old; miscarriage (including spontaneous abortion and induced abortion) not less than 2 times.
New treatment: PARP inhibitors provide an "increase" in the efficacy of radiotherapy. Recently, JAMA Oncology published a study saying that PARP inhibitors can provide an "increase" in the efficacy of radiotherapy. Under the treatment of 200mg dose PARP inhibitor (Orapanil), the 3-year event-free survival rate of triple negative breast cancer patients reached 65%, and the 3-year overall survival rate reached 83%. As the "first kind" of anticancer therapy successfully approved to market using the concept of "synthetic lethal", PARP inhibitors may be used as radiosensitizers, bringing new surprises for anti-tumor therapy.
◉ gastric cancer
Some countries take the age of 50 as the age to start screening, but there is no clear age standard for screening in China. If it is a person with a clear genetic family history, it is recommended to start screening before the age of the earliest sick relative. Gastroscopy should be performed as soon as possible to rule out gastric cancer if there are symptoms such as fullness, indigestion and epigastric pain.
People over 40 years old and with high risk factors can be screened for the first time by gastroscopy. If the test result is negative and there is no genetic history, screening can be carried out every 5-10 years. Patients with precancerous lesions such as chronic atrophic gastritis and gastric polyps should be actively treated, and gastroscopy should be performed again within one year. When precancerous lesions are found to disappear after two consecutive examinations, to enter the routine screening stage. Routine screening included detection of serum pepsinogen, gastrin-17 and Helicobacter pylori.
High-risk groups: in areas with high incidence of gastric cancer, Helicobacter pylori infection, history of gastric ulcer, family history of gastric cancer and so on.
New therapy: CAR-T cell therapy. In a study published in the journal Nature Medicine, Professor Shen Lin's team from Beijing Cancer Hospital demonstrated to the world the research results of Chinese Claudin 18.2 CAR-T in the treatment of gastric cancer. Claudin 18.2 is a pan-tumor target and is expressed in a variety of epithelial tumors, especially in gastric and pancreatic cancer. High expression of Claudin 18.2 was detected in up to 60% of patients with gastric cancer or gastroesophageal junction cancer. Based on this, Chinese researchers have developed the world's first CAR-T cell therapy for Claudin18.2-CT041. The results of preclinical studies of CT041 cells in the treatment of gastric cancer showed that gastric tumor could be completely removed in mouse model, and there was no miss toxicity.
◉ liver cancer
The high-risk group of liver cancer was examined by serum alpha-fetoprotein (AFP) and liver B-ultrasound at least once every 6 months. Adult patients with liver cirrhosis have the highest risk of developing liver cancer, and the examination interval should be shortened. Hepatitis patients are recommended to check the viral load every three months, do a B-ultrasound, and check a liver function.
High-risk groups: patients with hepatitis B or C virus infection; chronic alcoholism; non-alcoholic fatty liver; family history of liver cancer; liver cirrhosis caused by various causes; patients with hereditary metabolic diseases; patients with drug-induced liver damage.
New therapy: PD-1 inhibitor combination therapy. According to the official website of the State Drug Administration, the application for new indications of Hengrui Medicine Anti-PD-1 Monoclonal Antibody for injection of Carrilizumab has been approved, combined with apatinib (Aitan) ("double Ai" combination) for first-line treatment of advanced hepatocellular carcinoma, which is the ninth indication approved by Carrilizumab in China. It is also the first combination of PD-1 inhibitors and small molecular anti-angiogenic drugs approved for the treatment of advanced hepatocellular carcinoma in China, bringing new drug options for patients with advanced liver cancer.
Beijing News reporter Zhang Zhaohui
Proofread Zhao Lin