MILAN (ITALPRESS) – Colon cancer is the second most common cancer in women after breast cancer and the third in men after prostate and lung cancer. An estimated 50,500 colon cancer diagnoses were made in Italy in 2023. A key tool for detecting and preventing colon cancer is colonoscopy, a diagnostic examination that allows direct examination of the surface of this section of the intestine and any changes in it. During the same colonoscopy, polyps can be removed and then subjected to histological examination to ascertain the benign or malignant nature of the alteration. These are some of the topics discussed by Gianluigi Toti, a specialist in digestive tract surgery and digestive endoscopy, long on the board of directors of the Italian Society of Digestive Endoscopy and currently at the San Camillo nursing home in Milan, interviewed by Marco Klinger, for Medicina Top, a TV format of the Italpress news agency. “The first colonoscopy was performed in 1969, then evidently it was left somewhat in oblivion, until the 2000s, when regional and national laws imposed it as a screening method for colon prevention,” he began, “Something had to be done to prevent this cancer, the numbers had risen beyond expectations. Going into more detail, the professor explained what it means to perform a colonoscopy: “The endoscopic device is basically a surgical device,” Toti pointed out, “The first function of the colonoscopy was diagnostic, to be able to evaluate from the real thing the lesions that until recently were only seen with radiology, in short, all those diagnoses that could not be made before. Also, you can tell whether the same lesion is benign or malignant,” he recounted, “You can determine the surface area of the lesion, and through Japanese classifications you can tell. “In colonoscopy you have to look at the whole colon, it’s important what we call pancolonscopy,” Toti added, “It used to be that we looked only at the left tract, today it has to reach the whole surface, even the last part of the intestine. Operative colonoscopy has arrived at really important developments: “Through the operative channels we can introduce some accessories, this has begun to allow cutting and coagulation as the surgeon does,” explained the professor. “We have begun to remove the first lesions, lately with some techniques we are beginning to remove superficial malignancies, so colonoscopy is no longer diagnostic but also curative. The other part of the lion’s share in operative colonoscopy is urgency, so bleeding, occlusions, or it is used to resolve occlusion states that used to go to surgery and can be addressed this way today.” And on the future prospects of colonoscopy: “Definitely artificial intelligence, which is bringing into colonoscopes the ability to recognize polypoid or precancerous lesions on their own, to mark to the endoscopist where they are, to make then an already precise target of where to go to hit,” he stressed, “The technology allows for almost microscopic zooming and viewing capabilities, to make very precise diagnoses. Colonoscopy remains a dreaded exam for patients, but in recent years it has become less and less invasive: “It is feared because there is a foreign body. Pain no longer exists; there has been an evolution in technique and also in the skills of those who perform them. Today, a colonoscopy has to meet certain international standards, those who face an examination have to go to a reference center where there is security that these standards are met,” Toti recommended. “It is no longer performed ‘a crudò, but through sedation. “In Italy, colonoscopy is recommended to first-degree relatives of those who have had colon cancer, in other countries it is proposed after the age of 55 and if you don’t have risk factors you don’t do anything anymore,” he concluded, “Even in Italy the idea of doing it once in a lifetime and then doing nothing more is emerging.
– photo taken from Top Medicine video -(ITALPRESS).
