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Europacolon shows the improvements, and what still needs to be done, in treating colorectal #cancer

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EuropacolonOn Wednesday March 1, the start of Colon Cancer Awareness Month, an advocacy group called EuropaColon hosted an event that laid out the problems and solutions facing Europeans who suffer from the disease. Doctors and professors came to explain how colorectal cancer treatment has changed and improved over the years to the MEPs who could hopefully push forward legislation to deal with the problem, writes Jack Harvel.
In Europe alone there are an estimated 471,000 cases of colorectal cancer a year, 228,000 of which will end in death. It is the fourth most common form of cancer worldwide and the second most common in Europe. It is often deadly because screening for the disease is an unattractive prospect to patients, but this is changing.
Generally a screening would be recommended by a patient’s doctor and done at his or her own discretion. However, population screening informs the entire population of the risks of colorectal cancer, and invites them to be screened.
“There was a European recommendation at the end of 2003 saying that [population screening] should happen, and it’s a paradox that it’s taking such a long time to get it out,” Professor Stephen Halloran MBE, said.
Despite this recommendation, many member states have been slow to adopt the policy. EuropaColon only named eight member states making good progress in screening: Belgium, France, Ireland, Italy, Netherlands, Malta and Slovenia.
Advances in the screening process have made testing for cancer easier. Where a colonoscopy used to be the only way to check, now there is fecal testing, blood sampling and capsule endoscopy (in which a tiny camera is swallowed to observe the digestive tract).
To be completely cured of colorectal cancer, surgery is necessary. Over time colorectal surgery has evolved to become less intrusive and less cosmetically damaging. This includes smaller incisions, the use of internal cameras and “robots” to conduct surgery. But that doesn’t mean surgery works alone.
“We do work in multidisciplinary teams and we need to integrate surgery with other treatment modalities so that we can get the best outcome for our patients,” Santiago González Moreno, Medical Director of the Anderson Center, said.
Other treatments such as radiotherapy, chemotherapy, and the use of biological agents can minimize existing tumors before being operated on.
Population screening, multidisciplinary treatment and advances in surgery are shown to drastically reduce the mortality rate for colorectal cancer. However the results don’t show across the board.
“Quality of care is crucial and is important, because you see variations in Europe, you see variations within each country,” Eric Van Cutsem, a Professor of Gastrointestinal Oncology at UZ Leuven, said.
People in lower income countries are less likely to receive high quality treatment than more wealthy ones.
“Around half [of member states] are showing a decreasing mortality rate, but the other half is increasing… it’s the treatment that’s the main factor,” Halloran said.
 
Colorectal cancer is a much more manageable problem using these strategies, but many member states are slow to adopt the policies. The European Commission has drafted legislation to fight against colorectal cancer twice, and both times it was struck down in parliament.
“There isn’t political will to change things, and without political will we can’t move forward,” Jola Gore-Booth, the CEO of EuropaColon, said.

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