How to prevent "ingested" cancer
2024-07-01
Esophageal and gastric cancer are common malignant tumors that seriously threaten the health of Chinese residents. Recently, the National Health Commission issued the "Esophageal Cancer Screening and Early Diagnosis and Treatment Plan (2024 Edition)" and "Gastric Cancer Screening and Early Diagnosis and Treatment Plan (2024 Edition)". What are the key points of the introduction of the two plans? How to prevent esophageal and gastric cancer? How to diagnose and treat early? Experts have interpreted this. The high-risk population of esophageal cancer is ≥ 45 years old, and meets any one of the following: (1) Living in an area with high incidence of esophageal cancer (defined by county-level administrative regions, the age standardized incidence rate based on China's population structure in 2000 is>15/100000). （2） Parents, children, brothers, sisters and other first-degree relatives have a history of esophageal cancer. （3） Bad dietary habits and lifestyle habits such as hot pot diet, high salt diet, pickled food, smoking, and heavy alcohol consumption. （4） Suffering from chronic esophagitis, Barrett's esophagus, esophageal diverticulum, achalasia of the cardia, reflux esophagitis, benign esophageal stenosis, and other diseases. （5） Have a history of diagnosis and treatment of precancerous lesions in the esophagus. Excerpted from the Scheme for Screening, Early Diagnosis and Early Treatment of Esophageal Cancer (2024 Edition), the age of high-risk population for gastric cancer is ≥ 45 years old, and meets any of the following: (1) People living in areas with high incidence of gastric cancer (defined by county-level administrative regions, the age standardized incidence rate based on China's population structure in 2000 is>20/100000). （2） Parents, children, brothers, sisters and other first-degree relatives have a history of gastric cancer. （3） Urea breath test, serum Hp antibody, and fecal Hp antigen test are all positive. （4） Smoking, heavy alcohol consumption, high salt diet, pickled food and other unhealthy lifestyle and dietary habits. （5） Suffering from chronic atrophic gastritis, gastric ulcer, gastric polyp, residual stomach after surgery, hypertrophic gastritis, pernicious anemia and other diseases. Excerpted from "Screening and Early Diagnosis and Treatment Plan for Gastric Cancer (2024 Edition)", it prefers to eat while it is hot and be careful not to scald. Esophageal cancer is one of the common malignant tumors worldwide. According to global cancer statistics in 2020, the number of new cases and deaths of esophageal cancer reached 604000. China is a high incidence area of esophageal cancer. Although the incidence rate and mortality of esophageal cancer in China are declining, it is still one of the main malignant tumors threatening the health of Chinese residents. "The esophagus is a tubular passage through which food enters the stomach through the mouth and is one of the most important digestive organs in the human body. Malignant tumors that occur on the esophageal mucosal epithelium are esophageal cancer, and the main histological type of esophageal cancer in China is squamous cell carcinoma." Chai Huiping, chief physician of the Department of Thoracic Surgery at the First Affiliated Hospital of Anhui Medical University, introduced that the "Esophageal Cancer Screening and Early Diagnosis and Treatment Plan (2024 Edition)" clearly points out that the main risk factors for esophageal cancer include specific dietary habits, unhealthy lifestyles, related medical history, and genetic factors. For example, Chinese people prefer hot food in their diet and advocate for 'eating while it's hot' and 'drinking while it's hot'. Freshly cooked hot tea and hotpot may have a better flavor, but this' heat 'must be well controlled, as excessively hot tea and food can easily irritate and damage the esophageal mucosa Chai Huiping introduced that in general, after damage to the esophageal mucosa, self repair will be initiated. However, if the diet is too hot for a long time, the mucosa will continuously cycle the process of "damage repair". Over time, the esophageal mucosa may exhibit atypical hyperplasia and precancerous lesions, increasing the risk of cancer. Therefore, it is necessary to control the temperature of the food and avoid eating too hot food. Chai Huiping introduced that a preference for pickled, smoked, grilled foods or frequent consumption of moldy foods can also increase the risk of developing esophageal cancer. Pickled, grilled, smoked, and fried foods contain a lot of nitrite, which enters the human body and produces nitrosamines. Moldy foods are prone to producing aflatoxins, both of which are strong carcinogens. In areas with high incidence of esophageal cancer, such as the area near the Taihang Mountains, many residents used to like hot and hot food and eat more pickled and smoked food, such as pickled Chinese cabbage and bacon, which increased the risk of esophageal cancer. Later, through efforts, many people changed their bad eating habits, and the incidence rate of food tube cancer decreased significantly. "In addition, smoking and excessive alcohol consumption are also one of the risk factors for esophageal cancer." Chai Huiping reminds that in order to reduce the risk of esophageal cancer, it is necessary to change unhealthy eating habits and lifestyles. For example, avoid eating particularly dry, hard, or hot foods, avoid overnight vegetables, avoid moldy foods, eat less or no pickled, smoked, or grilled foods, match your diet reasonably to balance nutrition, consume foods rich in vitamins, trace elements, and dietary fiber, and eat more fresh vegetables and fruits. At the same time, quit smoking, drinking alcohol or drinking less, and chew slowly while eating. Stay away from gastric cancer and actively eradicate Helicobacter pylori. Gastric cancer refers to epithelial malignant tumors that originate from the stomach. According to the latest data of China in 2020, the incidence rate and mortality of gastric cancer rank third in all kinds of malignant tumors. Approximately 1.2 million new cases of gastric cancer occur globally each year, with China accounting for approximately 40% of them. On a global scale, East Asia is a region with a high incidence of gastric cancer. There are many risk factors for gastric cancer, and age is an important one. The risk of gastric cancer increases with age. The incidence rate of gastric cancer is less than 1/100000 before the age of 25, but the incidence rate will increase year by year after the age of 45. " Li Zhemin, Deputy Chief Physician of the Gastrointestinal Oncology Center of Peking University Cancer Hospital, introduced that the "Screening and Early Diagnosis and Treatment Plan for Gastric Cancer (2024 Edition)" comprehensively lists the main risk factors for gastric cancer from five aspects: environment, genetics, infection, lifestyle, and past medical history, and clearly defines the high-risk population for gastric cancer. The "Screening and Early Diagnosis and Treatment Plan for Gastric Cancer (2024 Edition)" clearly states that Helicobacter pylori (Hp) infection is one of the main risk factors for gastric cancer. If infected with Helicobacter pylori, is it not far from gastric cancer? Not really. Studies have found that Helicobacter pylori infection does increase the risk of gastric cancer. The incidence rate of gastric cancer is also high in areas with high positive detection rate of Helicobacter pylori. However, being infected with Helicobacter pylori does not necessarily mean that one will definitely develop stomach cancer in the future Li Zhemin introduced that, like other tumors, the occurrence of gastric cancer is a complex process with multiple factors and steps. Genetic factors, environmental factors, bad lifestyle habits, and past medical history are closely related to the occurrence of gastric cancer. Helicobacter pylori itself can cause chronic inflammation, peptic ulcers, etc. Therefore, even if most infected individuals have no symptoms, it is recommended to actively eradicate Helicobacter pylori and reduce the risk of gastric cancer if conditions permit. Most people's stomach cancer is not hereditary, and having relatives sick does not necessarily mean that they will also have cancer. But if a family member's immediate relatives have a stomach cancer patient, then the risk of other members getting the disease will indeed increase Li Zhemin introduced that smoking, heavy alcohol consumption, unclean diet, preference for pickled foods, high salt diet and other dietary habits can also increase the risk of gastric cancer. In addition, those who have previously suffered from pre gastric cancer diseases such as chronic atrophic gastritis, gastric ulcers, gastric polyps, and residual stomach after surgery are also at high risk of gastric cancer. They should regularly go to the hospital for examination to achieve early prevention, detection, and treatment. Early symptoms are not obvious, and regular screening is a key expert introduction. Whether it is for esophageal cancer or gastric cancer, both plans emphasize the need for early diagnosis and treatment. However, most esophageal and gastric cancers do not have obvious clinical symptoms in the early stages. When patients show symptoms and seek medical attention in the hospital, they often progress to the middle and late stages, missing the optimal treatment window and increasing the medical burden. "Early stage esophageal cancer usually does not have special symptoms, while the typical symptom of mid to late stage esophageal cancer is progressive dysphagia, starting with difficult to swallow dry food, followed by semi liquid food, and finally difficulty swallowing water and saliva." Chai Huiping introduced that the prognosis of advanced esophageal cancer is poor. In recent years, although the 5-year survival rate of patients with advanced esophageal cancer in China has improved, it is still at a relatively low level. If detected and treated early, the 5-year survival rate of patients can be significantly improved. For gastric cancer, the effectiveness of treatment varies depending on the time of discovery. More than 90% of early gastric cancer can be cured, but if it is advanced or advanced gastric cancer, the overall 5-year survival rate is less than 50% Li Zhemin emphasized that for most people, only through screening can they know if their stomach has undergone any changes. Both options recommend endoscopic examination for screening esophageal and gastric cancer. It is recommended that high-risk individuals for esophageal and gastric cancer undergo endoscopic examination every 5 years in principle, and for those with related lesions, it is recommended to shorten the screening interval. "One of the highlights of these two plans is their targeted nature, emphasizing screening for high-risk individuals with esophageal and gastric cancer." Li Zhemin introduced that, taking gastric cancer as an example, the incidence rate of gastric cancer in the general population is low. Endoscopic examination for gastric cancer census requires a lot of human and material resources, and patients have low acceptance. Therefore, only screening for high-risk populations is an effective method. "For individuals over 40 years old with a family history of malignant tumors, it is recommended to undergo an annual routine physical examination containing endoscopic examination." Chai Huiping introduced that for esophageal and gastric cancer, endoscopic examination is commonly referred to as gastroscopy. Regular gastroscopy examination for high-risk individuals is beneficial for early detection of abnormalities in the esophagus and stomach. Once early lesions are detected, they can be removed through gastroscopy for biopsy to determine the nature of the lesion. When conditions permit, the lesion can also be directly removed under gastroscopy for early treatment. On social media, some netizens have expressed reluctance to undergo gastroscopy due to fear of pain. "In fact, painless gastroscopy examination is now quite common. For screeners, they just need to sleep and the examination ends unconsciously." Li Zhemin reminds that prevention, screening, and early diagnosis are the most economical and effective means of treating tumors. To stay away from esophageal and gastric cancer, it is not only necessary to pay attention to early screening, but also to establish the concept of a healthy life, cultivate healthy eating habits and lifestyle. (Lai Xin She)
Edit：Xiong Dafei Responsible editor：Li Xiang
Source：GMW.cn
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