Lieberman D A, Atkin W
Portland Veterans Administration Hospital - P3-GI, Portland, Oregon 97239-1034, USA.
Aliment Pharmacol Ther. 2004 Feb;19 Suppl 1:71-6. doi: 10.1111/j.0953-0673.2004.01842.x.
Colorectal cancer is responsible for over 500 000 deaths annually world-wide. Death from colorectal cancer is preventable, primarily through early diagnosis of disease that has not metastasized. The disease itself may be prevented by the detection and removal of colorectal adenomas, from which more than 95% of colorectal cancers arise. Currently there are several screening methods for the disease. These include faecal occult blood tests, sigmoidoscopy, barium enema and colonscopy as well as emerging methods of virtual colonoscopy and faecal DNA testing. While direct and indirect evidence support the efficacy of these tests they differ from each other in their sensitivity, specificity, cost, and safety. Various professional organizations in different geographical regions of the world have published recommendations on which screening methods to use and when in patients at average- or high-risk. The challenge in reducing the incidence and mortality of this disease lies in increasing accessibility to and compliance with screening and delivery within a quality assured programme.
全球范围内，结直肠癌每年导致超过50万人死亡。结直肠癌导致的死亡是可以预防的，主要通过对尚未发生转移的疾病进行早期诊断。通过检测和切除结直肠腺瘤可预防该疾病本身，超过95%的结直肠癌由结直肠腺瘤发展而来。目前有多种针对该疾病的筛查方法。这些方法包括粪便潜血试验、乙状结肠镜检查、钡剂灌肠和结肠镜检查，以及新兴的虚拟结肠镜检查和粪便DNA检测方法。虽然直接和间接证据均支持这些检测方法的有效性，但它们在敏感性、特异性、成本和安全性方面存在差异。世界不同地理区域的各种专业组织已发布了关于使用何种筛查方法以及何时对平均风险或高风险患者进行筛查的建议。降低该疾病发病率和死亡率的挑战在于，在质量有保证的项目中，提高筛查的可及性、患者的依从性以及筛查服务的提供。
