Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Policlinico, Via Del Pozzo 71, Modena 41124, Italy.
Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Policlinico, Via Del Pozzo 71, Modena 41124, Italy.
Eur J Intern Med. 2015 Dec;26(10):752-6. doi: 10.1016/j.ejim.2015.08.019. Epub 2015 Oct 21.
Prevention is the main strategy in order to reduce colorectal cancer incidence and mortality. It can be accomplished through primary prevention, using measures affecting factors known to confer higher risk of colorectal cancer, or through secondary prevention, aimed at early diagnosis of cancer or preneoplastic lesions in groups of subjects at increased risk of cancer. Although primary prevention should be the goal for future years, because it acts on the probable causes of colorectal cancer, at present it seems that secondary prevention is more effective on colorectal cancer survival, and the approaches which have yielded the most satisfying results, in terms of reduced mortality for cancer, are those aimed at detecting preneoplastic lesions, or cancer at an early stage in selected groups of subjects at average or increased risk of colorectal cancer. These groups are subjects aged 50years or older, affected individuals (gene carriers) or family members of hereditary colorectal cancer syndromes (i.e., Lynch syndrome and familial adenomatous polyposis), and patients with inflammatory bowel diseases. The most effective procedures used, though with some drawbacks, are fecal occult blood tests and colonoscopy. Future research should be addressed to find new approaches that will render preventive strategies more acceptable for the population, and more cost-effective.
预防是降低结直肠癌发病率和死亡率的主要策略。它可以通过初级预防来实现，即采取影响已知增加结直肠癌风险因素的措施，也可以通过二级预防来实现，即针对癌症或癌前病变在高危人群中的早期诊断。虽然初级预防应该是未来几年的目标，因为它针对结直肠癌的可能原因，但目前看来，二级预防对结直肠癌的生存更有效，并且在降低癌症死亡率方面取得最令人满意结果的方法是针对特定高危人群中的癌前病变或早期癌症进行检测。这些人群是年龄在 50 岁或以上的人群、遗传性结直肠癌综合征（即林奇综合征和家族性腺瘤性息肉病）的受影响个体（基因携带者）或家庭成员，以及炎症性肠病患者。虽然这些方法存在一些缺点，但粪便潜血试验和结肠镜检查是最有效的方法。未来的研究应该致力于寻找新的方法，使预防策略更能被人群接受，并更具成本效益。
