[Secondary prevention of colon cancer]

Each year more than 6000 patients in Poland die from cancer of the colon. Morbidity due to colonic cancer increases rapidly in our country. From 1973 to 1982 there was a three-fold increase in the morbidity due to colonic cancer as compared to the years 1952-1955. Five-year relative survival in the same periods did not improve, either being 28% in men and 27% in women. To compare, in the USA with high morbidity rates due to colonic cancer where each year there are 145,000 new cases of cancer, 5-year relative survival is 42% for men and 54% for women. This raises a question whether our strategy of treatment of colonic cancer is correct. This question is even more justified now when secondary prevention of colonic cancer is of practical value. Total mortality due to colonic cancer is 60%. However, diagnosis and treatment of early forms of colonic cancer reduces mortality to 20% and below. Therefore, effective management colonic cancer should include not only the so-called primary prevention (interfering with etiological factors for instance through high fibers diet) but also secondary prevention through monitoring of precancerous changes in the colon, removal of potentially malignant lesions and early forms of colonic cancer [19]. Secondary prevention interfering with the pathogenesis of colonic cancer is the subject of the present paper. We would like to emphasize the need for a better management program for colonic cancer, especially that the data concerning colonic cancer in Poland may be underestimated due to diagnostic neglect and faulty cancer register.(ABSTRACT TRUNCATED AT 250 WORDS)