Mars Bleu 2022 in Monaco

Written by: Dr Henri VINTI and Dr Philippe PASQUIER

The Mars Bleu (Blue March) initiative aims to raise public awareness about colorectal cancer and promote screening for the disease in Monaco.

A review five years after the introduction of the quantitative immunological test OC-Sensor for colorectal cancer screening at the Monaco Screening Centre (CMD).

Between 2017 and 2021, the CMD sent 33,550 letters to individuals aged 50–80 years old and covered by the Monaco Social Security Funds, inviting them to take advantage of the screening programme.

A total of 8,912 tests were received and analysed at the Princess Grace Hospital laboratory, accounting for 27% of those sent out.

Of these, 369 tests (around 4%) were positive, with a detection threshold lowered to 100 ng/ml in Monaco (it is 150 for the French screening programme).

Two hundred and eighty-six people received a colonoscopy:
● 92 of these were normal
● in 167 cases, one or several polyps were identified (and resected); of these polyps, 67 were considered to be advanced neoplasia
● 27 confirmed cancers were diagnosed

Colonoscopy can detect polyps, which are small growths in the mucous membrane of your colon, as well as cancerous tumours at an early stage when they are easier to treat.

Overall, it can be noted that while a third of colonoscopies are normal, a third highlighted one or more benign polyps with the potential to become malignant, and a third helped to identify and cure cases of colorectal cancer.

With 43,000 new cases and 18,000 deaths every year in France, colorectal cancer is the second leading cause of cancer mortality in men and the third in women.

Immunological test

The quantitative immunological tests to detect faecal haemoglobin currently on the market are a successful replacement for the previous Hemoccult test, offering two advantages: acceptability, since only one sample is required where previously two were required from three consecutive stools (i.e. six in total), and sensitivity, since these tests can detect up to four times more cancerous or pre-cancerous lesions. Please note that this test is aimed at the “standard” risk population with no symptoms in the age range identified. In the event of any personal or family history of polyps and/or colorectal cancer, a colonoscopy should be sought.

Screening for colorectal cancer in Monaco

Once you receive your invitation letter, you can pick up the test kit from the CMD, your usual doctor or the Office of Occupational Medicine during a check-up. The sample can be returned to the CMD or posted, free of charge, in a pre-addressed envelope to the Princess Grace Hospital laboratory. The results are sent to the individual concerned and their doctor the week after the test is received by the laboratory. If the test is negative, you should get another one in two years. If the test is positive, your doctor will be contacted directly by the CMD to arrange the necessary colonoscopy.

Colorectal cancer can be screened for and is therefore preventable. So don’t wait any longer, if you’re in the target group, get yourself tested!