CANCER

Colorectal (bowel) cancer

According to the National Health Service of Latvia, colorectal cancer is one of the most common cancers in Latvia. It is diagnosed in more than 1 000 people each year, about half of whom are diagnosed late – at stages III and IV.

Danute Ražuka-Ebela, a gastroenterologist at Gastro center, explains:

If cancer is detected late, the outcome is expected to be significantly worse than if it were detected early. The earlier cancer is detected, the better it is treated. With higher stages of cancer, survival decreases, as shown by the figures: the European average is 99% for stage I, 68-83% for stage II and only 45-65% for stage III, five years after diagnosis of colorectal cancer.

Colorectal cancer screening

Colonoscopy plays a crucial role in colorectal cancer (CRC) screening, as it establishes the diagnosis of the tumour. A properly organised, planned and performed colonoscopy is therefore an important and particularly important examination for the patient, which will largely determine both the diagnosis and further treatment planning.

The nationally organised colorectal cancer screening programme in Latvia uses a combined screening method – a patient selection test – immunohistochemical detection of human haemoglobin in a faecal sample, followed by a diagnostic colonoscopy in individuals with a positive selection test result.

For colorectal cancer screening in general clinical practice, colonoscopy may be used as a primary procedure or in combination with a faecal blood test, depending on the specific situation.

Two very important advantages of colonoscopy are the possibility of tissue sampling (biopsy) and the possibility of removing a neoplasm (polyp or tumour) from the bowel (polypectomy).
Morphological examination of tissue samples taken during colonoscopy is crucial to confirm the diagnosis of a tumour.

The effectiveness of an organised colorectal screening programme is influenced by several factors, one of the most important being the quality of the colonoscopy. Screening colonoscopy is a complex procedure consisting of several important and interrelated steps, including pre- and post-colonoscopy periods. These include patient information, colonoscopy timing, preparation of the patient and his/her bowel for colonoscopy, medication, colonoscopy procedure (including tissue sampling and polypectomy), tissue morphology, diagnosis by combining colonoscopy and morphology results, recommendations, planning of the next colonoscopy.

The adequacy of the colonoscopy and related processes is strongly influenced by the skill, experience, quality of the equipment and infrastructure of the institution.

The most important criteria for the quality of the colonoscopy procedure are the degree of bowel cleanliness, the adequacy of the examination of the bowel lumen, the technique of tissue sampling and polypectomy and the quality of the morphological examination of the tissue (usually performed in a laboratory in another institution). The timing of bowel examination and the frequency of finding adenomas are validated, easily quantifiable and comparable criteria that we recommend to use.

A quality colonoscopy ensures an adequate endoscopic and morphological diagnosis, individualised recommendations for the patient and an important contribution to the screening programme.

For 3 years now, the Gastro Center has been operating a colorectal cancer (CRC) screening room equipped with the latest and most modern endoscopy technology. It is a specially equipped endoscopy room with the highest class and quality endoscopy, anaesthesia and patient monitoring technologies, including an artificial intelligence system to increase diagnostic efficiency. In Latvia we offer the most advanced technologies in Europe and the world in endoscopic examinations and in the diagnosis, prevention and treatment of CRC.