MDL doctor: ‘You don’t notice anything from bowel cancer for a long time’
If you are between 55 and 75 years of age, you will receive a test for colon cancer once every two years. This allows colon cancer to be detected in time. But not everyone participates, many people have questions. You can now put that to the doubt telephone. Read 7 frequently asked questions here.
‘Since the bowel cancer population screening, my consulting room has really looked different,’ says Manon Spaander. In addition to being a gastroenterologist, she is also a professor of gastrointestinal oncology with a special focus on screening and early detection. ‘In the past I often had to deliver the bad news that someone had colon cancer and that the tumor had spread. That means: major surgery and the colon cancer was often no longer curable. Those are tough conversations, with sad partners and family members involved. But now I can say more and more often that someone can still be cured, thanks to the bowel cancer screening programme. We can detect the disease in the pre-stage and remove polyps.’
Poo under the microscope
Doing average 7 out of 10 people with us to the bowel cancer screening programme. But fewer people participate in the big cities. Also in Rotterdam, where Spaander works at Erasmus MC. ‘Everyone can decide for themselves whether to participate or not. But when you make the choice, it is important that you know how it is. People often have questions.’
Spaander discovered this when she and her team went to a shopping center in South Rotterdam to provide information under the motto ‘Take a closer look at your poop’. They had dressed it up playfully with a large inflatable large intestine and Zeeland boluses as a treat. The Algemeen Dagblad made an article about it. “People came from far and wide to the mall to ask questions. They even got in the car for it.’
Reason, therefore, to open the doubt telephone for the bowel cancer population screening. Erasmus MC already had a doubt telephone for people who had questions about the corona vaccines. You can now also call the same line for questions about the bowel cancer screening programme.
Seven questions
These are seven frequently asked questions to the doubt telephone about the bowel cancer population screening:
1. What complaints do you get with colon cancer?
Spaander: ‘The insidious thing about colorectal cancer is that you don’t have any symptoms in the early stage of the disease. You don’t notice it. That is why the bowel cancer screening program started in 2014. You will receive a purple envelope at home with a tube in it. You collect some faeces in it and send it to the lab. Then you get the result.
If you get symptoms between tests, it is always important to see a doctor. Complaints of colon cancer are: sudden change in stool, blood in your stool or abdominal pain.’
2. What does a positive stool test mean?
‘If the test is positive, blood is found in the stool. Colon cancer always develops from a polyp. That is a bulge on the inside of the intestine. Large polyps and tumors give off blood, hence the test. But there are many other causes of blood in the stool, such as a hemorrhoid, a wound, or some other type of bulge. A viewing survey provides certainty. Only 5% of people with blood in their stools have colon cancer. Don’t think too easily: ‘Oh, that must have been my hemorrhoid’. A viewing survey is really necessary. During the visual examination, the polyps are removed, if they are indeed present. After that you don’t have to do a new stool test for a longer period of time.’
3. Why is the call every two years?
‘You can also do it every year, but that is quite taxing. That is why it has been decided to test once every two years. They do it that way abroad too.’
There may also be an investigation into this interim period. Can he no longer be attuned to the person? Read the advice about the research here.
4. I have not taken a test, but now I want to participate. Is that still possible?
‘Do you still have the purple envelope with the test at home? Then check whether the test is still within the best-before date. The expiry date is stated on the vial (year and month). If so, you can take the test and send it. Has the expiration date passed? Request a new stool test at https://www.volksonderzoeknederland.nl/contact/
5. I am over 75 years old. Why can’t I participate in the population screening?
‘The chance that you will still get colon cancer after the age of 75 is smaller. Colon cancer is most common between the ages of 55-75. It is especially important that you participate in the population screening every time during that period. That makes the test extra reliable. Very occasionally the test does not find blood, even though there is a polyp. That is why it is important to participate in every call. Colon cancer grows very slowly, so the polyp will be discovered and removed during the next test.’
6. What happens during a viewing survey?
‘You get a medicine that cleans the intestine well. The cleaner, the less likely the endoscopist will miss abnormalities. You start at the end of the afternoon, drink a liter and again the next day. This is followed by the visual examination with a sedative, so that you feel less of it. A tube with a camera goes into your large intestine through your anus (poo hole). The colon is completely examined for abnormalities. The moment polyps can be seen, they are removed. We often hear afterwards: was this all? The research itself with the snake is not so bad. But that laxative is quite a task. The laxative doesn’t taste good.’
7. How much does it cost to participate in the bowel cancer screening programme?
‘The population screening is free, you don’t have to pay for the test. The viewing examination is reimbursed from the basic insurance. The costs fall under the deductibleso people who have not yet used up, pay a maximum of 385 euros after this viewing survey.
Call with questions
The doubt telephone for bowel cancer is available for personal answers. The line is available Monday to Friday from 8.30am to 1pm. The lines are staffed by trained medical students. On Wednesdays there are also Turkish speaking students and on Fridays there are Arabic speaking students. Dutch speaking students are there every day.
The number is 088-7555777
Would you like to know more about the bowel cancer screening programme? Listen here to the podcast with Manon Spaander and Karin Wismeijer, who was discovered by the population screening for bowel cancer: https://amazingerasmusmc.nl/oncologie/volksonderzoek-darmkanker-wel-of-niet-meedoen/
