In the Philippines, colorectal cancer is the third most common cancer and the fourth leading cause of cancer-related deaths. In 2022, there were 20,736 new cases of colorectal cancer with 10,692 deaths reported in the country.
In observance of National Colorectal Cancer Awareness Month, we highlight the importance of screening in detecting colorectal cancer early and significantly lowering the risk of dying from the disease.
Colorectal cancer is a disease in which abnormal cells in the colon or rectum divide uncontrollably, ultimately forming a malignant tumor. Individuals can lower their risk for colorectal cancer by maintaining a healthy weight; engaging in regular physical activity; eating a diet rich in vegetables, fruits, and whole grains, and low in red and processed meats; and refraining from drinking alcohol and smoking cigarettes.
Most colorectal cancers begin as an abnormal growth or lesion, called a polyp, in the tissue that lines the inner surface of the colon or rectum. Colorectal polyps are common in people older than 50 years of age, and most do not become cancer. However, a certain type of polyp known as an adenoma is more likely to become a cancer, according to the National Cancer Institute at the US National Institutes of Health.
Common symptoms of colorectal cancer include a change in bowel habits; blood in or on your stool; diarrhea, constipation, or a feeling that the bowel does not empty all the way; abdominal pain, aches, or cramps that don’t go away; and unexplained weight loss. However, precancerous polyps and colorectal cancer don’t always cause symptoms, especially in the early stages of the disease. This is why individuals need to get screened even if they do not have a family history, as most colorectal cancers occur in people with no family history of the disease, the US Centers for Disease Control and Prevention (CDC) said.
With early detection, colorectal cancer is one of the most preventable and treatable of cancers. Screening helps prevent colorectal cancer by finding precancerous polyps so these can be removed before they turn into cancer. With early detection through screening, treatment can be very effective.
The Philippine Society of Gastroenterology (PSG) recommends regular screening through a fecal immunochemical test (FIT) and colonoscopy starting at age 50 for the prevention, early detection, and treatment of early-stage colorectal cancer.
FIT is a simple test that can be performed at home. Recommended yearly, it detects hidden blood in the stool, which can be an early sign of cancer. However, FIT cannot diagnose colorectal cancer and therefore individuals with positive FIT results should schedule a colonoscopy with a gastroenterologist as soon as possible.
Colonoscopy is the gold standard screening method for colorectal cancer. A colonoscopy is an exam in which a long, flexible tube (a colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the gastroenterologist to view the inside of the entire colon and rectum to check for and remove precancerous polyps.
A vast majority (86%) of Filipino adults (20 years and older) are willing to participate in colorectal cancer screening programs initiated by the government, and almost half (47%) are amenable to undergoing screening tests even as an out-of-pocket expense. These are among the key findings of “Knowledge, Attitudes, and Practices in Colorectal Cancer Screening in the Philippines,” a cross-sectional study by Fernandez et al published in December 2024 in the open-access, international peer-reviewed journal Acta Medica Philippina. The study involved 288 respondents with a median age of 54 residing in both urban and rural communities in the country.
The study also revealed that public awareness about colorectal cancer and the benefits of screening remains modest. Respondents with higher household income and highest educational attainment were more knowledgeable about the benefits of colorectal screening.
While the cost of a colonoscopy is understandably an issue, screening is less expensive than treating colorectal cancer if compliance rates are high and the costs of screening tests are reasonable, writes Dr. David Beck, editor-in-chief of The Oschner Journal, in his editorial on the importance of colorectal cancer screening. “In perspective, the health advantages of screening should certainly outweigh the equivalent of several months of cable television [subscription] or expensive mobile data plans.”
Fernandez et al stated that the findings of their study can help policymakers design and implement directed educational campaigns to address knowledge gaps. They can also clarify misconceptions and overcome barriers to colorectal cancer screening with the overall goal of increasing participation rates in screening programs.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.
