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结肠癌及癌前病变的筛查。

Screening for cancerous and precancerous conditions of the colon.

作者信息

Julka Manjula, Cherukuri Manjula, Lameh Rahele

机构信息

Department of Family and Community Medicine, University of Texas Southwestern Medical Center at Dallas, 6263 Harry Hines Boulevard, Clinical Building 1, Forest Park Road Suite#651, Dallas, TX 75390-9165, USA.

出版信息

Prim Care. 2011 Sep;38(3):449-68; viii. doi: 10.1016/j.pop.2011.05.009.

DOI:10.1016/j.pop.2011.05.009
PMID:21872091
Abstract

Five points for the primary care physician: 1. Colorectal cancer (CRC) is the second leading cause of cancer-related death in both men and women in the United States. 2. Guidelines recommend initiating CRC screening in average-risk patients at age 50 years, but in African Americans at age 45 years. 3. It is preferred that an informed decision is made by the patient with the help of their clinician about the type of screening test based on the patient's personal preferences. 4. Patients with personal history of chronic ulcerative colitis and Crohn colitis have significant cancer risk 8 years after the onset of pancolitis or 12 to 15 years after the onset of left-sided colitis. Colonoscopy every 1 to 2 years should be performed, with biopsies for dysplasia. 5. Counseling to consider genetic testing and early screening recommendations for those with personal or family history of familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer.

摘要

初级保健医生需注意五点

  1. 在美国,结直肠癌(CRC)是男性和女性癌症相关死亡的第二大主要原因。2. 指南建议,平均风险患者在50岁开始进行CRC筛查,但非裔美国人在45岁开始。3. 最好由患者在临床医生的帮助下,根据患者个人偏好就筛查测试类型做出明智的决定。4. 有慢性溃疡性结肠炎和克罗恩结肠炎个人病史的患者,在全结肠炎发病8年后或左侧结肠炎发病12至15年后有显著的癌症风险。应每1至2年进行一次结肠镜检查,并对发育异常进行活检。5. 对于有家族性腺瘤性息肉病或遗传性非息肉病性结直肠癌个人或家族病史的患者,建议考虑进行基因检测并给出早期筛查建议。

相似文献

1
Screening for cancerous and precancerous conditions of the colon.结肠癌及癌前病变的筛查。
Prim Care. 2011 Sep;38(3):449-68; viii. doi: 10.1016/j.pop.2011.05.009.
2
Prophylactic Oophorectomy: Reducing the U.S. Death Rate from Epithelial Ovarian Cancer. A Continuing Debate.预防性卵巢切除术:降低美国上皮性卵巢癌死亡率。一场持续的争论。
Oncologist. 1996;1(5):326-330.
3
Colorectal cancer: risk factors and recommendations for early detection.结直肠癌:风险因素及早期检测建议
Am Fam Physician. 1999 Jun;59(11):3083-92.
4
[Prevention and early detection of colorectal carcinoma by endoscopic examinations].[通过内镜检查预防和早期发现结直肠癌]
Z Gastroenterol. 1998 May;36(5):403-14.
5
Family history and colorectal cancer screening: a survey of physician knowledge and practice patterns.家族病史与结直肠癌筛查:医生知识与实践模式调查
Am J Gastroenterol. 2002 Apr;97(4):1031-6. doi: 10.1111/j.1572-0241.2002.05624.x.
6
Crohn's colitis: the incidence of dysplasia and adenocarcinoma in surgical patients.克罗恩病性结肠炎:外科手术患者发育异常和腺癌的发病率
Dis Colon Rectum. 2006 Jul;49(7):950-7. doi: 10.1007/s10350-006-0555-9.
7
Clinical inquiries. What's the most effective way to screen patients with a family history of colon cancer?
J Fam Pract. 2010 Mar;59(3):176-8.
8
Endoscopic screening for dysplasia and mucosal aneuploidy in adolescents and young adults with childhood onset colitis.对患有儿童期起病的结肠炎的青少年和青年进行内镜检查以筛查发育异常和黏膜非整倍体。
Am J Gastroenterol. 1997 Nov;92(11):2001-6.
9
Colon cancer in inflammatory bowel disease: recent trends, questions and answers.炎症性肠病中的结肠癌:近期趋势、问答
Gastroenterol Clin Biol. 2009 Jun;33 Suppl 3:S190-201. doi: 10.1016/S0399-8320(09)73154-9.
10
[Effectiveness and costs of screening colonoscopy].[结肠镜筛查的有效性和成本]
Fortschr Med. 1995 Sep 30;113(27):381-4.

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2
Single-cell spatial mapping reveals alteration of cell type composition and tissue microenvironment during early colorectal cancer formation.单细胞空间图谱揭示了结直肠癌早期形成过程中细胞类型组成和组织微环境的改变。
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