Cancer deaths 'could be halved if doctors knew more'

The mortality rate for colorectal cancer could be more than halved if health care professionals knew more about it, experts say.

ABU DHABI // The mortality rate for colorectal cancer could be more than halved if health care professionals knew more about it, experts said as an awareness campaign is about to begin.

They said some general practitioners unwittingly dismiss the cancer as being haemorrhoids, leading to late diagnosis.

Colorectal cancer occurs in the colon or rectum. Risk factors include age, family history, obesity, alcohol abuse and smoking, although the exact cause is unknown. It is the second most common cancer in the UAE, and the second highest cause of cancer deaths.

In 2010, 132 cases of colorectal cancer were diagnosed in the country, more than half of them in Abu Dhabi. Last year in the capital there were 47 deaths.

Overall, the most common cancer in the Emirates is breast cancer, which receives far more attention and is less lethal than colorectal cancer.

"We calculated the fatality rate, and for 2011 [in Abu Dhabi] this is 59 per cent. This is higher than breast cancer, which is only 44 per cent in comparison," said Dr Jalaa Taher, head of the cancer control and prevention section at the Health Authority-Abu Dhabi (Haad), speaking on the eve of Abu Dhabi's first awareness campaign on colorectal cancer.

Dr Salim Awadh, a consultant physician in gastroenterology and haematology at Gulf Diagnostic Center in the capital, said: "We have taken a big interest in breast cancer; it is high time we get involved with colorectal cancer,"

Dr Taher said a lack of knowledge among providers and the public contributed to 72 per cent of cases in 2010 being diagnosed at a late stage.

As with some other cancers, the survival rate is extremely high if the disease is caught early enough, Dr Taher said. "For the early stages, when the cancer is early or localised, the survival rate is 92 per cent."

Once the cancer has spread, the survival rate drops to between 10 and 20 per cent.

Around 85 per cent of cases were discovered in people over the age of 40, though the youngest patients were in their early to late teens. Dr Taher said the teenagers' cases, which are uncommon, were the result of a genetic predisposition.

He said 60 per cent of deaths from colorectal cancer could be prevented if doctors offered screening to high-risk patients.

Abu Dhabi's campaign will focus on educating health care providers as well as people who fall into the risk category.

"We aim to educate the community and to clarify any misconceptions of this disease," Dr Taher said.

Symptoms include abdominal pain and blood in your stool.

Screening allows doctors to check for polyps, tissue growths which are normally benign but that act as a precursor to colorectal cancer.

The campaign is meant to help doctors make patients feel more comfortable talking about - and consequently seeking treatment for - the cancer, said Dr Nigel Umar Beejay, a consultant gastroenterologist and chairman of health information at Sheikh Khalifa Medical City.

"We need implicit trust and confidence in the person who is going to be seeing you and discussing this treatment. It goes back to doctor-patient trust."

Teaching doctors is the main issue, Dr Awadh said.

At yesterday's event to kick off the awareness campaign, one doctor said there have been cases where general practitioners diagnose patients with piles or dysentery instead of looking further. "These people actually have polyps, so we need to focus on GPs and make them aware about colorectal cancer screening," the doctor said.

Dr Awadh, who sees four to eight cases of colorectal cancer a month, a quarter of which were diagnosed at a late stage, said health insurance is also a barrier.

At the Gulf Diagnostic Center, a colonoscopy - one of the more popular methods of screening, which involves checking the bowel via the anus - costs Dh3,500 and is not covered by basic insurance.

Further, Dr Awadh noted that as part of Haad's breast cancer campaigning, screenings are occasionally given free of charge in conjunction with insurers, an option that is not yet available for colorectal cancer screening.

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