Kim Seong-Eun, Hong Sung Pil, Kim Hyun-Soo, Lee Bo In, Kim Se Hyung, Hong Sung Noh, Yang Dong-Hoon, Lee Suck Ho, Shin Sung Jae, Park Dong Il, Kim Young-Ho, Yang Suk-Kyun, Kim Hyo Jong
Department of Internal Medicine, Ewha Womans University School of Medicine, Korea.
Korean J Gastroenterol. 2012 Jul;60(1):26-35. doi: 10.4166/kjg.2012.60.1.26.
BACKGROUND/AIMS: There is a paucity of national guideline for colorectal cancer screening and polyp diagnosis in Korea. Thus, we investigated the present state of colorectal cancer screening and polyp diagnosis methods using web-based survey to use as reference data for developing a guideline.
A multiple choice questionnaires of screening recommendations was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians who participated in the national colonoscopy surveillance program. Among 425 colonoscopists, a total 263 colonoscopists replied (response rate, 61.9%).
The most commonly recommended starting age for colorectal cancer screening and polyp diagnosis was 50 years old in the average risk group, and 40 years old in groups who had a family history of colon cancer (64.3% and 65.0% respectively). Surgeons had a tendency to recommend screening in younger people than internist do. Ninety-eight percent of physicians recommended screening colonoscopy to asymptomatic, average-risk patients as a first choice. Only 2% of physicians chose sigmoidoscopy as a screening tool. When the initial colonoscopy showed a negative finding, over 60% of internists repeated the exam 5 years later, whereas 62% of surgeons did so within 3 years.
The starting age of colorectal cancer screening and the interval of the colorectal polyp examination are not uniform in various medical environments, and there is a discrepancy between the practical recommendations and western guidelines. Thus, a new evidence-based national practice guideline for colorectal cancer screening and polyp diagnosis should be developed.
背景/目的:韩国缺乏关于结直肠癌筛查和息肉诊断的国家指南。因此,我们通过基于网络的调查来研究结直肠癌筛查和息肉诊断方法的现状,以作为制定指南的参考数据。
一份关于筛查建议的多项选择题问卷通过电子邮件发送给了韩国肠道疾病研究协会的成员以及参与国家结肠镜监测项目的基层医疗医生。在425名结肠镜检查医生中,共有263名医生回复(回复率为61.9%)。
在平均风险组中,结直肠癌筛查和息肉诊断最常推荐的起始年龄为50岁,有结肠癌家族史的组为40岁(分别为64.3%和65.0%)。外科医生比内科医生更倾向于推荐在较年轻的人群中进行筛查。98%的医生推荐对无症状的平均风险患者首选筛查结肠镜检查。只有2%的医生选择乙状结肠镜检查作为筛查工具。当初次结肠镜检查结果为阴性时,超过60%的内科医生在5年后重复检查,而62%的外科医生在3年内进行复查。
在不同的医疗环境中,结直肠癌筛查的起始年龄和结直肠息肉检查的间隔并不统一,实际建议与西方指南之间存在差异。因此,应制定一项基于新证据的结直肠癌筛查和息肉诊断国家实践指南。