Across Vietnam, increasing numbers of people are rushing to get blood tests in hopes of detecting multiple diseases early - especially cancer. However, health experts warn this trend is being fueled by misconceptions and in some cases, commercial pressures from healthcare providers.

Speaking at a roundtable on May 11 titled “Strategies for screening, diagnosis, and treatment of colorectal cancer in Vietnam” organized by the Nhan Dan newspaper, Assoc. Prof. Dr. Pham Cam Phuong, Director of the Center for Nuclear Medicine and Oncology at Bach Mai Hospital (Hanoi), strongly cautioned against the growing reliance on blood tests for cancer screening.

“This is a complete misconception,” Dr. Phuong said. She explained that most tumor markers in blood only become elevated in late-stage cancers, and are typically not reliable indicators of early-stage disease.

“Relying on a few blood test indicators to conclude whether someone has cancer is inaccurate and can either miss a diagnosis or cause unnecessary panic,” she added.

According to Dr. Phuong, proper screening begins with a physician assessing symptoms, medical history, and risk factors, followed by targeted testing - not blanket use of tumor marker tests.

Currently, blood-based screening is mostly appropriate for high-risk groups, such as:

Prostate cancer: Men over 50 may undergo abdominal ultrasound and a PSA (Prostate-Specific Antigen) blood test.

Hepatocellular carcinoma (liver cancer): High-risk individuals such as those with cirrhosis from alcohol or hepatitis B/C are typically screened using abdominal ultrasound and an AFP (Alpha-fetoprotein) blood test.

In contrast, for colorectal cancer, Dr. Phuong said blood tests and tumor markers are not suitable for early detection. Physicians must assess patient risk based on age, symptoms, family history, and medical background to recommend appropriate screenings such as colonoscopy.

She also pointed out that while cancer treatment guidelines are available in Vietnam, screening protocols remain lacking. Dr. Phuong expressed hope that the Ministry of Health will soon issue disease-specific screening recommendations, including for cancer, to curb unnecessary tests driven by revenue pressures.

“If health insurance were to cover screenings, that would be very meaningful. Early detection significantly reduces treatment costs and increases success rates - even offering a cure in some cases,” she noted.

Early screening is key – don’t wait for symptoms to act

Assoc. Prof. Dr. Vu Van Khien, Secretary-General of the Vietnam Society of Gastroenterology, emphasized that colorectal cancer is one of the leading public health threats in Vietnam. Data from Globocan 2022 shows the country recorded over 16,000 new cases and more than 8,400 deaths, ranking 4th in incidence and 5th in mortality among common cancers.

Alarmingly, the disease is affecting younger people, with cases increasingly seen in those aged 20–30. On a positive note, Dr. Khien stressed that colorectal cancer is highly treatable if detected early.

Health authorities recommend that people aged 45 and above begin screening, especially those experiencing symptoms like blood in the stool, unexplained abdominal pain lasting more than 2–3 weeks, or a family history of cancer. High-risk groups such as individuals with chronic inflammatory bowel disease or obesity may need to start screening even earlier.

Common screening methods include:

Colonoscopy
Fecal immunochemical test (FIT) or fecal occult blood test (FOBT)
Virtual colonoscopy
Biopsy of suspicious lesions
Multi-target stool DNA testing

Dr. Phuong added that thanks to advances in treatment, patients with late-stage colorectal cancer now have much longer survival prospects. In the past, metastatic patients survived only 6 months to a year.

Today, with personalized therapies and targeted treatments based on genetic mutations, survival time can reach up to 5 years in 30–40% of cases.

Vo Thu