Labianca Roberto, Merelli Barbara
Unit of Medical Oncology Ospedali Riuniti di Bergamo, Italy.
Tumori. 2010 Nov-Dec;96(6):889-901.
Colon cancer is the third most common cause of cancer diagnosed in the United States, and the second leading cause of cancer death. Although rates of the disease have been going down in recent years, results can be further improved. About 90% of people whose colon cancer is caught before it has spread to nearby lymph nodes or organs survive more than 5 years after diagnosis. However, only 10% of patients whose cancer has spread to distant parts of the body survive 5 years. Diagnosis at an early stage aims to reduce the incidence of tumors in an advanced stage and hence mortality.
We analyzed the literature to understand what new tests to use and new directions to take.
There is evidence to support the screening of average-risk individuals over the age of 50 years to detect and prevent colon cancer. Screening of these people can only reduce mortality rates, not incidence, identifying cancer at an early stage and through the removal of clinically significant adenomas. Patient preferences and availability of resources play an important role in the selection of screening tests, because each test presents specific risks and specific benefits.
The American Cancer Society has added two new screening methods, CT colonography, also known as virtual colonoscopy, and stool DNA tests to the list of options. A small revolution in screening for colon cancer is in the making. The availability of these less invasive tests should increase the number of people who undergo regular screening.
结肠癌是美国诊断出的第三大常见癌症，也是第二大致癌死亡原因。尽管近年来该疾病的发病率有所下降，但结果仍可进一步改善。约90%的结肠癌在扩散至附近淋巴结或器官之前被发现的患者在诊断后存活超过5年。然而，只有10%的癌症已扩散至身体远处部位的患者能存活5年。早期诊断旨在降低晚期肿瘤的发病率，从而降低死亡率。
我们分析了文献，以了解应使用哪些新测试以及采取哪些新方向。
有证据支持对50岁以上的平均风险个体进行筛查，以检测和预防结肠癌。对这些人的筛查只能降低死亡率，而非发病率，通过早期发现癌症并切除具有临床意义的腺瘤来实现。患者偏好和资源可用性在筛查测试的选择中起着重要作用，因为每种测试都有特定的风险和特定的益处。
美国癌症协会已将两种新的筛查方法，即CT结肠成像（也称为虚拟结肠镜检查）和粪便DNA检测，添加到筛查选项列表中。结肠癌筛查正在发生一场小变革。这些侵入性较小的测试的可用性应会增加接受定期筛查的人数。
