Walsh Judith M E, Terdiman Jonathan P
Division of General Internal Medicine, Department of Medicine, Women's Health Clinical Research Center, University of California San Francisco, Campus Box 1793, 1635 Divisadero Suite 600, San Francisco, CA 94115, USA.
JAMA. 2003 Mar 12;289(10):1297-302. doi: 10.1001/jama.289.10.1297.
Screening for colorectal cancer reduces mortality in individuals aged 50 years or older. A number of screening tests, including fecal occult blood tests, sigmoidoscopy, double-contrast barium enema, and colonoscopy, are recommended by professional organizations for colorectal cancer screening, yet the rates of colorectal cancer screening remain low. Questions regarding the quality of evidence for each screening test, whether screening for individuals at higher risk should be modified, the availability of the tests, and cost-effectiveness are addressed. Many potential barriers to colorectal cancer screening exist for the patient and the physician. Strategies to increase compliance for colorectal cancer screening are proposed.
对50岁及以上人群进行结直肠癌筛查可降低死亡率。专业组织推荐了多种筛查测试，包括粪便潜血试验、乙状结肠镜检查、双对比钡灌肠和结肠镜检查，但结直肠癌筛查率仍然很低。文中探讨了有关每种筛查测试的证据质量、是否应调整对高危个体的筛查、测试的可及性以及成本效益等问题。患者和医生在结直肠癌筛查方面存在许多潜在障碍。文中还提出了提高结直肠癌筛查依从性的策略。
