Bond John H
Am J Gastroenterol. 2006 Feb;101(2):263-5. doi: 10.1111/j.1572-0241.2006.00426.x.
Recent large series of direct colonoscopy screening for colorectal cancer increase our understanding of the advantages of this approach, and have indirectly confirmed efficacy. When performed by well-trained, experienced endoscopists, colonoscopy screening is successful and safe. The prevalence of advanced neoplasia is low under the age of 50 yr but increases substantially with each decade of life thereafter at least until the age of 80 yr. Most detected cancers are at an early, curable stage. A substantial number of proximal advanced neoplasia are detected that would be missed by screening flexible sigmoidoscopy. Widespread population-based colonoscopy screening would markedly decrease the incidence and mortality of this major malignancy. Issues of compliance and capacity related to direct colonoscopy have not yet been adequately addressed.
近期针对结直肠癌进行的大量直接结肠镜筛查系列研究增进了我们对这种方法优势的理解，并间接证实了其有效性。由训练有素、经验丰富的内镜医师进行结肠镜筛查是成功且安全的。50岁以下人群中晚期瘤变的患病率较低，但此后每增加一个十年患病率就大幅上升，至少持续到80岁。大多数检测到的癌症处于早期可治愈阶段。通过筛查乙状结肠镜检查会漏诊的大量近端晚期瘤变能够被检测出来。基于人群的广泛结肠镜筛查将显著降低这种主要恶性肿瘤的发病率和死亡率。与直接结肠镜检查相关的依从性和能力问题尚未得到充分解决。
