Dr Lim Lee Guan, gastroenterologist in Singapore at the Specialist Care Group, explains about gastric intestinal metaplasia and colonic tubular adenoma. These are 2 examples of pre-cancerous conditions that may lead to stomach cancer or lead to colorectal cancer. Fortunately, they can be picked up by gastroscopy and colonoscopy respectively.
Gastric Intestinal Metaplasia And Stomach Cancer
Gastric intestinal metaplasia is a condition whereby normal cells which line the surface of the stomach wall is replaced by intestinal-type cells. This can happen as a result of long-term injury. This is a pre-cancerous condition that can result in stomach cancer.
Patients with gastric intestinal metaplasia have a higher risk of getting stomach cancer compared to people without the condition. However, most patients with gastric intestinal metaplasia do not develop stomach cancer.
Intestinal Metaplasia Can Be Diagnosed Through Gastroscopy
Intestinal metaplasia can be diagnosed through gastroscopy (examination of the stomach using a flexible tube with a small camera inserted through the mouth) and confirmed with biopsy of tissue specimens extracted during gastroscopy, before it becomes cancerous.
The follow-up and treatment for this condition is should be discussed with your doctor.
Tubular Adenomas May Lead To Colorectal Cancer
Tubular adenomas are polyps found in the colon that have the potential to become cancerous and lead to colorectal cancer. Tubular adenomas may have low grade dysplasia or high grade dysplasia (abnormal development of cells). A higher grade dysplasia is associated with greater risk of progression to cancer.
Detection And Removal Of Tubular Adenomas Via Colonoscopy
Colonoscopy (an examination of the large intestine using a flexible tube with a small camera inserted via the anus) is one of the few ways to screen for colorectal cancer. Another way would be through stool testing (faecal occult blood test) for blood in the stool, which is a symptom of colorectal cancer.
Colorectal cancer can be prevented if pre-cancerous polyps are detected and removed before they become cancerous during colonoscopy. Tubular adenomas that are detected during colonoscopy should be removed to prevent progression to cancer. The interval between follow-up colonoscopy varies with the number, type, size and microscopic feature of the polyps found. Your doctor can advise you on this based on your colonoscopy findings.
What Are The Recommended Guidelines For Patients To Undergo Gastroscopy And Colonoscopy To Screen For Cancer?
There are no national guidelines in Singapore for when a person should go for gastroscopy as a screening for stomach cancer. In Korea, where stomach cancer survival rates are high, asymptomatic people 40 years old or older are invited to undergo endoscopy or upper gastrointestinal series (X-ray examination of the upper gastrointestinal tract) every 2 years. If you have a family history of stomach cancer and are aged 40 and above, you may similarly consider undergoing a gastroscopy.
With regards to colorectal cancer screening, the Ministry of Health recommends undergoing a colonoscopy once every 10 years for asymptomatic people aged 50 and above. A faecal occult blood test should be done annually.
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.