Health officials mull colorectal cancer screening rollout – PM

Barbadians could soon benefit from a colorectal screening programme through the Ministry of Health, which is now assessing the cost and logistics of introducing the initiative, Prime Minister Mia Mottley revealed at Monday night’s St Philip Ideas Forum.

She said that the ministry was reviewing the introduction of a colorectal screening programme but had not yet given the final approval:

“I know that the Ministry of Health is looking at it. They have not signed off, and I suspect that they are in a position now where they’re trying to settle the numbers both in terms of the cost, the individual unit costs, and then the range.”

The announcement came in response to gastroenterologist Dr Marek Stobinski, who called for a greater focus on early detection of colorectal cancer. He recently moved to Barbados and is practising at Bayview Hospital and a private clinic.

He told the forum at the Princess Margaret Secondary School that he was unable to find a national colorectal cancer screening programme when he explored ways to contribute to the country’s healthcare system:

“I started looking for prophylactic programmes, and I cannot find any in Barbados, so I’ll be like a biggest advocate for a colorectal cancer screening programme in Barbados.”

He stressed the importance of screening as colorectal cancer no longer only affects older people, noting that he diagnosed the disease in an otherwise healthy 40-year-old man:

“I had my concerns that we need to do something before the cancer spread, and it will be too late for treatment.”

Early detection could prevent colorectal cancer from progressing, as precancerous growths known as polyps can be removed before they develop into cancer. 

Dr Stobinski said: “In the early stage, like polyps, we can remove it in 15 minutes. It’s not a big deal and to prevent building the cancers and the spread [of] metastasis in the wrong body,” he said. 

Mottley, too, stressed the importance of early detection, citing the 1999 death of Barbados and West Indies cricket legend Malcolm Marshall at age 41 as an example of the need for screening:

“How old Malcolm Marshall was when he died? You think he would’ve died if he had the screening and they did the surgery?”  

The prime minister also said she undergoes regular colonoscopies and noted that removing polyps can significantly reduce the risk of developing cancer:

“If you find the polyps and remove them, you do what? Minimise. Doctors tell me don’t ever use the word extinguish, but you minimise the chance of cancer to almost zero.”

St Philip North MP Dr Sonia Browne, a general practitioner, also stressed that follow-up care remained a major challenge when patients were identified as high risk:

“The headache seems to be the follow-up when you do have, you found the patient.”

She added that while cost was a consideration, screening and early intervention were more cost-effective than treating patients once the disease had advanced.

Mottley underscored the significance of screening for major cancers, including breast, prostate and colorectal cancers, to detect illnesses early, which improves the chances of recovery.

“Because if you get in early, you do what? Give yourself a credible chance of recovery and full life again.”

She also gave broad hints that the government is mulling the introduction of GLP-1 anti-obesity drugs, focusing on whether the long-term benefits would outweigh the initial costs.

Mottley said while some treatments may appear expensive upfront, they could reduce future spending associated with serious health complications such as amputations and dialysis.

“We’re not going to end up being penny wise and pound foolish, but we will be strategic in our deployment of resources to be able to help people help themselves and to save lives,” she said.

The World Health Organisation (WHO) has issued landmark guidelines conditionally recommending GLP-1 receptor agonists – such as semaglutide, liraglutide, and tirzepatide – for the long-term treatment of adults with obesity. The WHO stresses that these medications must be combined with lifestyle interventions such as healthy diets and physical activity.

GLP-1s have proven to be effective weight-loss medications that typically help patients shed ten per cent to 20 per cent of their body weight. These drugs reduce appetite and “food noise” but frequently cause gastrointestinal side effects, and stopping the medication often results in significant weight regain.

(LG)