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2023 version of "Cancer Screening Recommendation" released! The addition of two new cancers cannot be ignored

Interviewed expert: Zheng Ying, chairman of the Cancer Screening and Prevention Committee of Shanghai Anti-Cancer Association and professor of Fudan University Cancer Hospital

Global Times health client reporter Shan Qiwen

In the mainland, more than 10,000 people suffer from cancer every day, and one person is diagnosed with cancer every 8 seconds, and the risk of cancer in Chinese people is as high as 37% in their lifetime. The World Health Organization proposes that nearly half of all cancers are preventable, and half of the cancers that cannot be prevented can be cured through early screening. It can be seen that scientific prevention is particularly important.

2023 version of "Cancer Screening Recommendation" released! The addition of two new cancers cannot be ignored

Recently, the Shanghai Anti-Cancer Association released the 2023 edition of the "Recommendations for Screening and Prevention of Common Malignant Tumors in Residents" (hereinafter referred to as the "Recommendations"). Since 2018, the Shanghai Anti-Cancer Association will release this document during the Cancer Prevention and Control Publicity Week every year, compared with the previous version of the 5 years, the 2023 version of the "Recommendation" has added the prevention and screening of oral cancer and children's tumors, and also specially compiled a chapter of "Vaccines can prevent cancer". Why there is such a change, the reporter of "Global Times Health Client" interviewed Zheng Ying, one of the editorial board members of "Recommendation", chairman of the Cancer Screening and Prevention Special Committee of Shanghai Anti-Cancer Association, and professor of Fudan University Cancer Hospital.

"Although oral cancer is rare, it has a clear screening method, which is simple and convenient. Routine oral examination can detect signs early, which can be said to be the most cost-effective cancer screening program. Zheng Ying said that the International Center for Research on Cancer has included oral cancer in the population screening program, which to a certain extent shows its necessity.

"In fact, the risk of tumors in children is very low, and the reason why this content was added is to attract the attention of parents." Zheng Ying introduced that from a clinical point of view, children's tumors are easy to delay treatment, and many parents will not think of tumors even if they find that their children have symptoms. At the same time, if pediatric cancer patients can achieve early detection and early treatment, the prognosis is much better than that of adult patients, and cure can basically be achieved.

For these two newly added cancers, the "Recommendation" gives a clear division of high-risk groups and prevention and screening recommendations.

Oral cancer. High-risk objects are divided into the following categories: 1. Long-term poor oral hygiene, with a history of oral mucosa such as erythema and leukoplakia. 2. Tooth defects (residual roots, crowns, poor restorations, long-term irritation or wear and tear of oral mucosa, etc.) cause mouth ulcers that have not healed for a long time. 3. Long-term HPV infection, especially HPV16 type infection. 4. Those with a family history of oral cancer. 5. Those who have long-term betel nut chewing, smoking, alcohol and other bad living habits. 6. Long-term vitamin A deficiency.

Screening suggestions: 2~4 clinical oral examinations for the general population every year, including the internal organs of the mouth, such as the tongue, gums, palate, cheeks, floor of the mouth, etc. In addition to clinical oral examination, laboratory tests and imaging tests can be added in high-risk groups, and biopsy if necessary to confirm the diagnosis.

Prevention suggestions: 1. Pay attention to oral hygiene, regular examination, and eliminate pathogenic factors. 2. Quit betel nut, quit smoking and alcohol, and develop good living habits. 3. Healthy diet, increase crude fiber and fresh fruit intake. 4. Get vaccinated against HPV.

Childhood tumors. High-risk subjects are divided into the following categories: 1. First-degree relatives (parents and siblings) with genetically related tumors or children with tumor-related genes. 2. Children with multiple homogeneous second-degree relatives (grandparents, maternal grandparents, siblings, siblings) with genetically related tumors or carrying tumor-related genes. 3. Children whose parents are close relatives. 4. Fetuses that may have genetic changes during the mother's pregnancy, such as a large amount of radiation, smoking, second-hand smoke, virus infection and other external stimuli, may cause fetal genetic mutations in the mother. 5. There are non-tumor-specific manifestations related to tumors, such as multiple milk coffee spots, multiple intestinal polyps, etc.

Screening suggestions: children should be alert to early symptoms of childhood tumors, such as unexplained bleeding, including bleeding gums, skin bleeding spots or ecchymoses, or often accompanied by fatigue, loss of appetite, anemia and other phenomena; fever of unknown origin or swollen lymph nodes, especially fever that does not respond to antiviral or antibiotic therapy, or if the child's fever of unknown origin lasts for more than 1 week and is accompanied by lymphadenopathy; Unexplained pain, long-term persistent or intermittent pain (headache, abdominal pain, joint pain, etc.), or neurological symptoms such as vomiting, unsteady walking, facial nerve paralysis, convulsions; In the short term, obvious weight loss, weight loss, endocrine disorders, precocious puberty, etc. In addition to the above symptoms, high-risk children should be screened for inherited tumor susceptibility genes and develop a physical examination plan according to the type of tumor susceptibility.

Prevention recommendations: Mothers stay away from smoking, especially exposure to secondhand smoke, during pregnancy; Pay attention to premarital and pre-pregnancy medical examinations to avoid marriage between close relatives; Pay attention to viral infections during pregnancy, especially in the first trimester, and attach importance to physical examination during pregnancy; Maintain hygiene and live a healthy life.

Zheng Ying said that there are currently two vaccines that can prevent cancer, one is the HPV vaccine and the other is the hepatitis B vaccine. The HPV vaccine can reduce cervical cancer (almost all cervical cancers are caused by HPV infection), vulvar cancer (25% of female vulvar cancer can be attributed to HPV infection), vaginal cancer (77% of vaginal cancers are attributed to HPV infection), penile cancer (53% of penile cancer is attributed to HPV infection), anal cancer (88% of anal cancers are caused by HPV infection), oral cancer (30% is attributed to HPV infection), oropharyngeal cancer (2% attributed to HPV infection), laryngeal cancer (2% Attributed to HPV infection) and other 8 types of cancer risk The hepatitis B vaccine protects against liver cancer caused by hepatitis B virus infection. "It is recommended that children be vaccinated against hepatitis B at birth, and adults who have not been vaccinated against hepatitis B are recommended to be vaccinated as soon as possible; Girls start receiving HPV vaccination from the age of 9, and boys are also recommended to be vaccinated if possible, the same from the age of 9; Women under the age of 45 who have not been vaccinated against HPV are recommended to be vaccinated as soon as possible; Women who have been infected with HPV can also receive the HPV vaccine after a doctor's evaluation.

According to the Recommendation, Fudan University Cancer Hospital has developed a "Common Malignant Tumor Risk Assessment Tool" to encourage everyone to know the risks, change their behavior, and participate in screening. Those who need it can scan the QR code at the end of the text to answer a series of questions, get a feedback report, and get cancer risk factors and suggestions for cancer prevention actions. ▲

Scan the code for cancer risk assessment↑

Responsible editor: Zhang Yu

Editor-in-chief: Xu Wenting

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