On April 21, during the 31st National Cancer Prevention and Treatment Promotion Week, a special interview on lung cancer and colorectal cancer in China's Health Knowledge Dissemination Incentive Program sponsored by the China Health Promotion Foundation was held in Beijing. Gu Yanhong, director of the Oncology Department of Jiangsu Provincial People's Hospital, Dong Xiaorong, director of the Thoracic Oncology Department of Union Hospital of Huazhong University of Science and Technology, and Xue Jianxin, director of the Thoracic Oncology Center of West China Hospital of Sichuan University, and Bai Yansong, director of the Health Knowledge Dissemination Incentive Program Project, discussed topics of public concern such as colorectal cancer and lung cancer prevention, characteristics of high-risk populations, screening, and tumor treatment, and put forward relevant suggestions to the public, and advocated the public to prevent cancer scientifically and live a healthy life.

According to relevant data released by the National Cancer Center, lung cancer is the first cancer among the morbidities and deaths in my country; in 2022, there were 1.0606 million new lung cancer cases in my country, accounting for 22.0% of all malignant tumors, and 733,300 deaths, accounting for 28.5% of all malignant tumors. Colorectal cancer is the second-ranked cancer among the entire population (total male and female) and males, and is showing an upward trend.

Gu Yanhong: Pay attention to colorectal cancer warning signals, early prevention and early screening, weight management and mood management

Gu Yanhong, director of the Oncology Department of Jiangsu Provincial People's Hospital and deputy chairman of the Colorectal Cancer Quality Control Expert Committee of the National Tumor Quality Control Center, pointed out that colorectal cancer is called the "stupidest cancer". It usually takes 5-10 years to develop from polyps to malignant tumors, which leaves a valuable window for both symptom warning and early screening. Gu Yanhong reminds the public to pay attention to early warning signals of the body, such as changes in bowel movements (such as obvious increase and decrease in frequency, thinning in shape), bloody stools, weight loss or anemia due to unknown reasons, are all possible symptoms of colorectal cancer.

Gu Yanhong said that staying up late, anxiety, fast food dependence and other lifestyles will increase the risk of colorectal cancer. In areas with conditions for colonoscopy, it is recommended that ordinary people over 50 years old undergo colonoscopy every 5 years, and the frequency of subsequent re-examination will be determined based on the results of colonoscopy. It is recommended that people with high-risk groups (such as those with family history or genetic diseases) be 40 years old or even earlier. Colonoscopy is not only the "gold standard" for screening, but also synchronously removes precancerous polyps when lesions are discovered. Gu Yanhong also specifically called for attention to fecal hiding blood test: "Many people give up this critical initial screening due to the cumbersome process, but a prompt of a positive result may save lives."

Recently, the National Health Association has included the "Healthy Weight Management Action" into the Healthy China Action, and this year is also the second year of the National Health Commission launching the "Healthy Weight Management Year". Regarding the issues of weight and colorectal cancer, Gu Yanhong pointed out that weight management not only involves physical and aesthetic issues, but also is an important tool for colorectal cancer prevention and treatment. She pointed out that obesity itself is a risk factor for colorectal cancer, and reminds the public that healthy lifestyles, including weight management, are conducive to the prevention of colorectal cancer.

Gu Yanhong specifically reminded that anxiety can also destroy the function of the intestinal barrier, and the positive mentality of "living in the present" is a natural immune regulator.

Dong Xiaorong: Face the risk factors of lung cancer and follow the doctor's advice to standardize treatment

Dong Xiaorong, director of the Department of Chest Oncology Center of Union Hospital, Huazhong University of Science and Technology and director of the Chinese Society of Clinical Oncology, said that the incidence and mortality of lung cancer rank first among all malignant tumors in my country, and the main risk factors include smoking, occupational exposure and chronic lung diseases. Smoking is the primary risk factor, and smokers have a higher risk of cancer than non-smokers, and the mortality rate has increased by 4-10 times. Among them, although small-cell lung cancer accounts for only 15%, it is highly malignant and prone to metastasis; non-small cell lung cancer accounts for 85%, among which subtypes such as adenocarcinoma and squamous cell carcinoma are highly correlated with smoking and mostly occur in the central bronchial area. Passive smoking (second-hand smoke, third-hand smoke) is also dangerous, especially smoke particles remaining in clothing and furniture.

Occupational exposures such as asbestos processing and air pollution (PM2.5, exhaust gas) will significantly increase the risk. In addition, chronic diseases such as tuberculosis and pulmonary fibrosis may develop into lung cancer, and family genetic factors cannot be ignored. The increase in the proportion of female patients in recent years may be related to the exposure of second-hand smoke and the PM2.5 produced by high-temperature stir-frying in the kitchen.

In terms of treatment, Dong Xiaorong first emphasized that the pathological classification of lung cancer determines the treatment direction. She pointed out that although small cell lung cancer (15%) is highly malignant and prone to metastasis, localized patients can significantly extend the median survival from 18 months of traditional treatment to 55.9 months through synchronous chemoradiation and PD-L1 inhibitors, close to a five-year survival milestone. For extensive-stage small-cell lung cancer, immunotherapy combined with chemotherapy has become a first-line solution, with the objective response rate increasing to 60%-70%. Dong Xiaorong specifically responded to the public's confusion about "chemotherapy" and other methods. Despite the rise of targeted and immunotherapy, chemotherapy is still an important means. With the progress of drug development, modern chemotherapy treatment plans have made significant progress in controlling side effects such as acute vomiting. Dong Xiaorong specifically reminded the patients to follow the doctor's instructions to avoid excessive panic.

Xue Jianxin: Don’t panic when dealing with lung nodules, and reduce risks with a healthy lifestyle

In response to the "pulmonary nodules" issue that is highly concerned by the public, Xue Jianxin, director of the Chest Cancer Center of West China Hospital of Sichuan University and chairman of the Youth Committee of the Integrated Cancer Branch of the China Anti-Cancer Association, pointed out that the detection of lung nodules does not mean that lung cancer is diagnosed. 95% of lung nodules are benign, and only 5% have the possibility of malignancy.

Xue Jianxin suggested that excessive anxiety should be avoided after nodules are found, and should be classified according to type and size under the guidance of the doctor: ground glass nodules (similar to lychee pulp) are reviewed every six months below 5 mm, and follow-up is required for 5 mm to 1 cm; mixed nodules (similar to lychee pulp and core coexist) are bounded by 8 mm, and less than 8 mm are followed up according to the step of 3-6-December, and greater than 8 mm, puncture or intervention is required; for completely solid nodules (similar to lychee pulp), doctors will give corresponding suggestions based on comprehensive judgments such as size and edge (burr signs). For some nodules, if the doctor gives anti-inflammatory treatment for 2-3 weeks, the possibility of malignancy can also be ruled out.

Xue Jianxin also pointed out that the prevention of lung cancer requires attention to a healthy lifestyle, and adopt the following methods: quit smoking (including second-hand smoke), reduce high-temperature cooking smoke exposure, control weight, and exercise moderately.

Xue Jianxin specifically reminds that men over 40 years old who smoke ≥400 per year are key people in lung cancer screening, and it is recommended to undergo low-dose spiral CT examination every year.

It is reported that this special interview on lung cancer and colorectal cancer in China's health knowledge dissemination incentive program was planned and implemented by the China Health Promotion Foundation. Many institutions, including the Health Communication Branch of the Chinese Preventive Medicine Association, the Age Communication Branch of the Chinese Gerontology and the Age Communication Branch of the Geriatric Society, provided professional and communication support for the special interviews of this Cancer Prevention and Treatment Propaganda Week.

[Editor in charge: Sun Hui]