El-Shami Khaled, Oeffinger Kevin C, Erb Nicole L, Willis Anne, Bretsch Jennifer K, Pratt-Chapman Mandi L, Cannady Rachel S, Wong Sandra L, Rose Johnie, Barbour April L, Stein Kevin D, Sharpe Katherine B, Brooks Durado D, Cowens-Alvarado Rebecca L
Assistant Professor of Medicine, The George Washington University, School of Medicine and Health Sciences, Washington, DC.
Director, Cancer Survivorship Center, Memorial Sloan Kettering Cancer Center, New York, NY.
CA Cancer J Clin. 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286. Epub 2015 Sep 8.
Colorectal cancer (CRC) is the third most common cancer and third leading cause of cancer death in both men and women and second leading cause of cancer death when men and women are combined in the United States (US). Almost two-thirds of CRC survivors are living 5 years after diagnosis. Considering the recent decline in both incidence and mortality, the prevalence of CRC survivors is likely to increase dramatically over the coming decades with the increase in rates of CRC screening, further advances in early detection and treatment and the aging and growth of the US population. Survivors are at risk for a CRC recurrence, a new primary CRC, other cancers, as well as both short-term and long-term adverse effects of the CRC and the modalities used to treat it. CRC survivors may also have psychological, reproductive, genetic, social, and employment concerns after treatment. Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of CRC survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
结直肠癌(CRC)是美国男性和女性中第三大常见癌症以及癌症死亡的第三大主要原因,若将男性和女性合并计算,则是癌症死亡的第二大主要原因。几乎三分之二的结直肠癌幸存者在确诊后能活5年。鉴于近期发病率和死亡率均有所下降,随着结直肠癌筛查率的提高、早期检测和治疗的进一步进展以及美国人口的老龄化和增长,未来几十年结直肠癌幸存者的患病率可能会大幅上升。幸存者面临结直肠癌复发、新发原发性结直肠癌、其他癌症的风险,以及结直肠癌及其治疗方式带来的短期和长期不良影响。结直肠癌幸存者在治疗后还可能存在心理、生殖、遗传、社会和就业方面的担忧。肿瘤专科医生与初级保健医生之间的沟通与护理协调对于有效且高效地管理结直肠癌幸存者的长期护理至关重要。本文中的指南旨在协助初级保健医生为已完成积极治疗的结直肠癌幸存者提供基于风险的医疗保健服务。