ESGE's public awareness campaign across the whole of Europe
Each year cancer of the intestine is diagnosed 135,000 times in Europe. Colon carcinoma is the second most frequent kind of malignant tumour after lung cancer for men and breast cancer for women. Mortality - at 60% - is high, and the prognosis depends on the disease being diagnosed at an early stage. A number of studies have shown a clear correlation between diet and frequency of cancer cases. There is at present no notable trend towards reducing the incidence or the high mortality rate. This points towards unhealthy eating patterns and ignorance of prevention and early diagnosis. The European Society of Gastrointestinal Endoscopy (ESGE) aims to counter this trend with a wide-ranging public awareness campaign.
Munich, 28 July 2000 - The formation of malignant tumours depends on three factors: genetic predisposition, age and environmental factors. A large number of carcinogens are absorbed along with drinking water, food and the air we breathe. Food is the most important of the environmental factors, accounting for 35% of cases. And don't forget that a person consumes 100 tonnes of food in the course of a lifetime. This food contains substances that stimulate the formation of cancerous growths, but also other ingredients that can help to prevent cancer. It is not necessary for carcinogenic substances to be absorbed in large amounts for them to be harmful; the accumulative effect of the regular absorption of small amounts over the years can be just as great.
Cancer of the intestine is particularly associated with a diet rich in fat and meat. In particular, a correlation has been established between cancer of the intestine and the consumption of animal fats and red meat as well as the intake of alcohol, and low consumption of fruit and vegetables. Other risk factors are a diet lacking roughage and physical inactivity, since this causes food to stay in the intestine longer. Various studies have also shown that there is a positive relationship between being overweight (adiposity) and cancer of the intestine.
A distinction must be made between different kinds of edible fats. They can be divided into 'good' and 'bad' fats. 'Good' fats contain unsaturated fatty acids and protect against the formation of cancerous growths. They are present in some kinds of fish and certain kinds of vegetable oils, like rape and olive oil. By contrast, 'bad' fats are animal fats, which contain saturated fatty acids. It is a matter of debate whether meat consumption and fat intake are to be considered as risk factors per se. Despite this, a recent Dutch study has shown beyond all possible doubt that there is a connection between meat that has undergone processing (smoking, pickling, drying, sausage making) and an increased risk of contracting cancer of the intestine.
Roughage refers to those organic components of food, such as cellulose, which are either not broken down at all, or only in part. The greater the amount of roughage, the greater the weight and volume of stool. This makes for a swifter passage through the intestines, which means that carcinogens come into contact with the wall of the intestine for a shorter period of time and also produces a dilution of the concentration of carcinogens. Roughage is present in grains and pulses (lentils, beans). However, this roughage alone will not act as a preventative against cancer, because it is not a source of vitamins. So preference should be given to fruit (redcurrants, blackcurrants, raspberries) and vegetables (Brussels sprouts, white cabbage) which are rich in roughage.
A balanced diet with plenty of fruit and vegetables ensures that the body is supplied with important vitamins. The vitamins C and E as well as beta-carotene (provitamin A) possess antioxidative properties. They help to prevent the formation of free radicals. These are highly reactive substances which can trigger off the mutation of a healthy cell into a tumorous one. It is highly probable that such foods contain other protective substances, so that the taking of vitamin pills is not to be recommended as an alternative to a balanced, natural, varied diet.
Around 90% of carcinomas develop from a benign preliminary stage, polyps. These are benign growths that mostly protrude into the intestine like mushrooms. It is possible for doctors to detect these growths early on through regular medical check-ups using, for example, colonoscopy and stool tests for occult blood. Stool tests, however, have a reliability factor of only 40-60%, depending on the stage of the cancer. And polyps as a preliminary stage of cancer are only discovered in 20% of cases using a stool test. A greater degree of reliability for the timely detection of cancer is offered by colonoscopy. Experts calculate that it permits mortality rates for cancer of the intestine to be reduced by half. This makes it essential for those over the age of 50 to undergo regular preventative examinations for cancer using colonoscopy.
Literature:
Prof Dr Volker Schusdziarra
II Med. Clinic and Polyclinic of the Technical University of Munich
Klinikum Rechts der Isar
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