Colorectal cancer among top three causes of death in Macau

Colorectal cancer, the second most prevalent cancer in Macau and a major cause of cancer-related deaths, has lowered its screening program age range to 50-69 years starting today, urging residents born between 1956 and 1975 to participate without requiring a colonoscopy right away.

According to the Health Bureau (SSM), since 2016, it has been running a colorectal cancer screening program for Macau residents aged 55 to 69. As of last month, over 31,000 eligible residents had participated, making up 17% of the target age group.

Among these participants, 2,999 were referred for further colonoscopy examinations, resulting in the detection of 312 cases of high-risk polyps and 168 confirmed cases of colorectal cancer. Approximately half of these cancers were diagnosed at stages 0 to 2, indicating early-stage cancer.

The SSM website indicated that as of the end of last year, 27,849 residents had completed fecal occult blood testing, with 3,079 testing positive.

These individuals were subsequently referred to subsidized private medical institutions for colonoscopy examinations funded by the government.

“We believe that colorectal cancer can be made more cost-effective through early prevention and treatment, which is crucial for people’s health. Therefore, increasing public participation is necessary. With the launch of the Healthy Macao Blueprint, we feel we should take proactive measures rather than a slow approach,” said Ng Ka Kei, a senior SSM official, at a press conference yesterday.

Regarding mandatory screening, he added that all medical procedures, including colorectal cancer screening, cannot be enforced, and the public’s wishes must be respected.

The physician reminded the public during a press conference yesterday to undergo regular screenings to detect low-risk and high-risk polyps early, as this can effectively prevent colorectal cancer.

“The five-year survival rate for stage 0 colorectal cancer can exceed 95% after treatment, while the five-year survival rate for stages I and II can reach 93% and over 80%, respectively,” he said.

In terms of mortality rates, data from Macau’s cancer registry system shows that the mortality rate from colorectal cancer has decreased by 12.6% over the past five years compared to before 2016, while the five-year survival rate for colorectal cancer patients has increased by 8%.

According to Ng, the decision to adjust the screening age for colorectal cancer to 50 to 69 years old was based on recent data and projections for future trends, considering the aging population and changes in dietary habits, along with guidance from the World Health Organization (WHO).

Additionally, there is a possibility that the age range for screening may be increased to include people aged 70 to 74 in the future if necessary.

The bureau reminded the public that if a fecal occult blood test yields a negative result, individuals should re-enroll in the screening program after two years, as no separate notifications will be issued.

If a colonoscopy has been performed previously, the next screening should take place five years later.

The authorities emphasize that there are currently three collaborating medical institutions in Macau offering colonoscopy services, which are sufficient to meet demand, so there is no need to seek assistance from other regions.

Among these institutions, Kiang Wu Hospital accounts for half of the quota, while the University Hospital and Yin Kui Hospital account for 30% and 20%, respectively.

“Over the past decade, the quota has always been sufficient, with appointments typically scheduled within one month. From receiving the referral letter to the report being returned to the health center, the entire process can be completed within one month,” Ng remarked.

Regarding hospital referrals, he assured that regular meetings are held with hospitals to coordinate and ensure the smooth operation of colonoscopy procedures.

The Health Bureau estimates that with the age range lowered, approximately 39,000 residents aged 50 to 54 will be eligible for screening.

If the participation rate reaches 10%, around 4,000 individuals are expected to take part in the colorectal cancer screening program. Eligible participants – those holding a Macau ID card who have not undergone a colonoscopy in the past five years, have not had a fecal occult blood test in the last two years, and have no history of colorectal cancer – can register through the Macao One Account or visit their designated health center to collect their stool sample collection bottles.

SSM issues warning about changes in daily habits

The Health Bureau informs the public that high-risk groups for colorectal cancer can be categorized into unmodifiable and modifiable risk factors. Unmodifiable factors include age, having a first-degree relative diagnosed with colorectal cancer, and personal medical history, such as previous colorectal polyps or inflammatory bowel disease. Modifiable factors relate to lifestyle choices, including an unbalanced diet, such as excessive red and processed meat consumption, lack of physical activity, obesity, smoking, and excessive alcohol intake.

If any of the following abnormal symptoms occur, it is crucial to seek medical attention promptly: significant changes in bowel habits, such as persistent diarrhea or constipation; abnormal stool shape, like narrow or pencil-like; discomfort after bowel movements; blood in the stool, which may be bright red or black; lower abdominal discomfort; persistent abdominal pain or bloating; unintentional weight loss; and unexplained fatigue or anemia. Immediate medical help is necessary if these symptoms arise.