Page 170 - Hospital Authority Convention 2017

Masterclasses Masterclasses
HOSPITAL AUTHORITY CONVENTION 2017

M9.1 Advances in Colorectal Cancer Management 09:00 Room 221

Colorectal Cancer Screening in Hong Kong
Ng S
Department of Surgery, The Chinese University of Hong Kong, Hong Kong
Colorectal cancer (CRC) has become the most common cancer in Hong Kong, and is also the second leading cause of
cancer deaths. Many studies have proven that early screening can result in a remarkable reduction in CRC incidence and
mortality. According to the Asia Pacific Consensus Recommendations on CRC Screening, subjects aged 50 to 75 years in
both genders are the targets for CRC screening, and faecal occult blood tests (guaiac-based and immunochemical tests),
as well as colonoscopy are the recommended screening tools. The Hong Kong SAR Government’s Cancer Expert Working
Group on Cancer Prevention and Screening also recommends that individuals aged 50 to 75 years should consider CRC
screening by various modalities. Supported by the Hong Kong Jockey Club Charities Trust, The Chinese University of Hong
Kong Jockey Club Bowel Cancer Education Centre launched a territory-wide CRC screening programme in May 2008. As of
December 2012, the Centre had conducted CRC screenings (with faecal tests and/or colonoscopy) for over 10,000 eligible
participants aged 50 to 70 without any symptoms of CRC. Among participants who had undergone colonoscopy, up to 30%
were found to have pre-cancerous lesions or CRC in the large bowel. In September 2016, the Hong Kong SAR Government
launched a three-year population-based CRC Screening Pilot Programme to subsidise individuals aged 61 to 70 to undergo
CRC screening using faecal immunochemical test followed by colonoscopy. The aims of the pilot programme are (1) to
determine the ability of the healthcare infrastructure in Hong Kong to handle the increasing demand for assessment and
follow-up treatment of cancer and pre-cancerous conditions; (2) to assess public understanding, perception, and acceptance
of CRC screening; and (3) to devise a screening algorithm with assured quality which is most suited to local needs and
circumstances.

M9.2 Advances in Colorectal Cancer Management 09:00 Room 221

Advance Endoscopic Intervention for Colonic Lesions
Chan PT
Department of Surgery, Queen Elizabeth Hospital, Hong Kong

Colonoscopy is one of the most common investigations of the lower gastrointestinal tract. It is used as a diagnostic tool to
Wednesday, 17 May En bloc resection by ESD helps to assess the resection margin of the lesion. It decreases the local recurrence when
detect benign and malignant lesions, as well as a channel for therapeutic intervention. In addition to conventional endoscopic
mucosal resection (EMR) for removing polyps, endoscopic submucosal dissection (ESD) is a new trend to treat large benign
polyp or early malignant lesion.

comparing with EMR. In certain early cancer cases, complete removal of lesion can avoid further colectomy. Paris
Classification, Kudo Classification and NBI Capillary Pattern can help us to select suitable patient for endoscopic submucosal
dissection while chromoendoscopy can give additional information.

ESD can be performed safely in endoscopic centre with intravenous sedation without the need of general anaesthesia by
trained doctors and nurses. Preparation of the patients includes diet restriction, bowel preparation, antibiotics, sedatives
and antispasmodic agents. Preparation of equipment includes water jet endoscope, CO2 insufflation, Hyaluronic acid,
endoscopic instruments like injector, dissector, coagulation grasper and haemostatic clips. Patients would resume diet
progressively post-operation and can be discharged in a few days. Common complications include bleeding and perforation.
With the launch of colorectal screening, more large benign polyps or early malignant lesion wound be found and more
patients would be expected to require this service.

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