Head of the Department of Surgery, Radiology, Anaesthesia and Intensive Care at the University of the West Indies (UWI), Professor Joseph Plummer, is imploring persons who have been instructed to do the necessary investigations for colorectal cancer not to put off doing these tests due to the pandemic, as the consequences could be dire.
He cited the case of a patient who delayed getting the tests done, and was later found to have metastatic liver disease, meaning that the cancer had spread to the liver.
Professor Plummer was speaking at the 12th annual Jamaica Cancer Society (JCS) Colon Cancer Medical Symposium held recently.
Colorectal cancer is the third leading cancer in males and females and the second leading cause of cancer-related deaths in Jamaica and the region.
Professor Plummer said that just about a third of persons diagnosed with colorectal cancer in the country will survive.
He said that Jamaica was projected to see about 500 to 600 new cases of colorectal cancer in 2020 and about 150 to 200 persons (a quarter to a third) will be alive and disease free five years post-diagnosis.
He pointed out that whereas colorectal cancer is decreasing in the United States because of screening and risk-factor modification, such as diet, it is increasing in Jamaica.
“Here, we think it’s a real increase rather than a more widespread use of colonoscopy and other diagnostic modalities to confirm the disease… so whereas that may be accounting for some increase, we think there is also a real increase,”
Professor Plummer also pointed out that in the United States, colorectal cancer is increasing in the younger population of black people and in particular the 18 to 45 age group, while in Jamaica, the disease is mostly seen in middle-aged persons.
“The mean age of diagnosis is 63, but we have seen patients as young as age 30 and as old as 99,”
Professor Plummer, in his remarks, emphasised the importance of routine screening of at-risk persons, which is anyone over the age of 45.
He lamented that in Jamaica, only 22 per cent of doctors routinely offer screening modalities for colorectal cancer to patients in their practice, and only about one per cent of patients with invasive carcinoma are diagnosed by screening.
In addition, he pointed out that while there are factors associated with the increased risk of colorectal cancer, such as “polyps, a personal history, a family history or a history of inflammatory bowel disease and the so-called westernised diet that is low in fibre, high in red meat, high in processed food and high in fat,” only about 20 per cent of patients actually have an identifiable risk factor.
As such, he said that colonoscopy screening should be emphasised.