The Value of Colon Cancer Screening in Developing Countries

Abstract Objectives: Colorectal cancer is the third most diagnosed cancer worldwide and the second most common cause of cancer death. If diagnosed at an early stage, however, it is one of the most curable malignancies. Patients with biopsy-proven adenocarcinoma of the colon without evidence of distant metastasis, and without contraindications to major surgery, are commonly treated with surgical resection. Methods and results: A 49-year-old male patient without any significant history is admitted at Surgery 5 Service, Cluj-Napoca for abdominal pain, diarrhoea, and important weight loss in the last 7 months. CT showed thickening of the sigmoid colon as well as bladder and small bowel invasion. The final diagnosis was completed by a colonoscopy and biopsy which was of stenotic sigmoid tumour, chemo treated. Unfortunately, the chemotherapy was unsuccessful, as the tumour did not regress. A multidisciplinary team was gathered debating the possibility of pelvic exenteration. As of surgical treatment, the following were performed: Sigmoidectomy with manual colo-rectal T-T anastomosis and central lymphadenectomy, ileal segmental resection with manual T-T anastomosis, resection of 2/3 of bladder, jejunostomy, evacuation of bladder abscess and the introduction of a double J ureteral stent. Consecutive to all procedures, the patient is in good health and can live a normal life. Conclusion: Even though surgery is curative in most cases of colorectal cancer, the survival rate of unoperated colorectal cancer is 0%. Thus, it is of utmost importance to diagnose colorectal cancer as soon as possible. Identification of populations at risk and screening of asymptomatic patients are therefore crucial imperatives.