The 70-year old celebrity Chu Ke-liang's news has called the public's attention over colorectal cancer. According to the data released by the Health Promotion Administration of the Ministry of Health and Welfare, colorectal cancer has been the cancer with the highest incidence rate for 8 consecutive years since 2006, while breast cancer has the highest incidence rate for women cancer. This means that about ten thousand citizens suffer from one or the other every year. As the early stage of colorectal cancer is presented with colorectal polyps, according to the statistics of CMUH Health Examination Center, among 4122 citizens who had colonoscopy last year, 26% was found with colorectal polyps, which means that one every four may have polyp; among 4309 women who had breast ultrasound examination, 4% was found with abnormalities and was recommended with a biopsy to rule out the possibility of malignant tumors. To achieve a more effective screening of breast cancer, this year the CMUH Health Examination Center purchased an “automatic full breast ultrasound scanning system” so as to provide a more comprehensive health check service for citizens in Central Taiwan.
The survival rate of early-stage colorectal cancer is more than 80% with at least five more years while the rate of breast cancer is more than 90%
There is no obvious symptom for early-stage colorectal cancer, so early detection can also be achieved through screening. Currently, the Health Promotion Administration provides citizens of 50 -74 years old one fecal occult blood test every two years. In case of abnormalities detected, colonoscopy would follow. As colorectal polyps or cancer can only be diagnosed with colonoscopy, several citizens would choose prefer to have it in their health checks. Some people worry that colonoscopy will be very uncomfortable or may have the risk of intestinal perforation; in fact, anesthesia may be opted for the examinations with professional gastroenterologist, so the examinee may sleep all the way through. With the anesthesiologists’ monitoring, the risk may also be adequately reduced. Dr. Chen, Yu-Lung from Family Medicine Department and Health Examination Center of CMUH suggested that whether it was colorectal cancer or breast cancer, there were effective screening tools at the moment, so treatment effect might be good in overall with early detections. The survival rate with more than five years of early colorectal cancer is more than 80%, while the survival rate of early breast cancer is more than 90%.
Breast ultrasound with periodic breast imaging may increase the detection rate of breast cancer
In terms of breast cancer prevention, 45-69 years old women are prone to breast cancer, so currently the government subsidized women of 45 – 69 years old one free mammography for examination every two years. Women whose second lineage relative has breast cancer may receive the subsidy at the age of forty. Dr. Chen, Yu-Lung indicated that periodic mammography is proven by medical research to be the most effective breast screening tool as it is highly sensitive to microcalcifications, but the accuracy is not 100%. About 15% of the breast cancer cannot be detected through this way, especially Asian women who normally have more delicate breast tissues. Thus, in addition to the mammography in Taiwan, beast ultrasound may be included to increase the detection rate of breast cancer. According to the statistics of CMUH Health Examination Center, among the citizens who had health check in our hospital in 2016, 4309 women had breast ultrasound examination. 174 women (4%) were recommended to have biopsy for a further examination of the lesion. 49 of the women who received biopsy, one had carcinoma in situ and three with the most common cancer, the invasive ductal carcinoma. It is worth to mention that one of the women who was diagnosed with breast cancer had mammography examination one week before the biopsy. The radiologist indicated that although it was known that she had abnormalities found in the ultrasound examination, it was not possibly detected in the mammography.
The automatic full breast ultrasound scanning system is an automatic carpet scan of the full breast with the machine, resulting in about 2000 images that can clearly show the lesions. It has good diagnosis rate for breast cancer less than 1 cm and ductal lesions. The CMUH Health Examination Center hopes that through the introduction of new machinery, the citizens in Central Taiwan might have more comprehensive breast examination services.
Family Medicine Health Center Dr. Liu, Chiu-Shong and Dr. Chen, Yu-Lung