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Factors Identified in Reducing Colorectal Cancer

Key Factors Identified in Reducing Colorectal Cancer

Improvements in surgical services, the introduction of screening, and consuming more fruit and vegetables are key factors in reducing the incidence of colorectal cancer and mortality, according to a study published in the latest issue of the New Zealand Medical Journal today.

About 1,300 men and 1,250 women in New Zealand develop colorectal cancer each year, making it the second most common cancer in men (after prostate cancer) and women (after breast cancer). Almost half this number, about 1140, die from colorectal cancer each year.

The study, by Associate Professor Brian Cox and Dr Mary J Sneyd of the University of Otago Medical School, focuses on activities offering a potential reduction in colorectal cancer deaths as identified from published international cancer control plans. These activities have been assessed individually, so their effects are not additive, but the figures give an indication of the benefits available.

The most straightforward control strategy would be to encourage every adult to increase intake of fruit and vegetables to 350 g/day. This would eventually reduce the deaths from colorectal cancer by about 137 per year, but the change would take several decades to have full impact.

Screening for colorectal cancer is another important strategy, with the prevention of 79 deaths per year by screening using faecal occult blood testing or 126 deaths per year through screening using flexible sigmoidoscopy.

Improvements in surgical practice and reorganisation of surgical services, together with improved use of radiotherapy and chemotherapy, could prevent about 160 deaths from colorectal cancer each year.

It was estimated that improved surgical training would prevent about 114 deaths per year (within 5 years), with a further 23 deaths per year possibly prevented from more targeted use of chemotherapy.

“This study illustrates that there is considerable scope for improved cancer control to reduce the burden of colorectal cancer in New Zealand, and indicates where efforts might be directed”, says NZ Medical Association Chairman Dr Boswell.

The study reports that nationally organised change in the treatment of rectal cancer is possible, and has been successfully implemented in Norway since 1993 with subsequent improved survival.


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