Janz Tyler, Lu Karen, Povlow Michael R, Urso Brittany
Medical Student, University of Central Florida College of Medicine.
Cureus. 2016 Dec 16;8(12):e931. doi: 10.7759/cureus.931.
Colorectal cancer (CRC) is the third leading cause of cancer death in the United States. Recently, more focus has been placed on developing effective screening tools to detect the presence of both precancerous and cancerous lesions present in the colon and rectum. Colonoscopy has been well established as the gold standard of the colon and rectal cancer screening. However, not all patients are willing to undergo a colonoscopy due to the procedure's invasive nature. Non-invasive screening methods have been developed to appeal to patients who refuse colonoscopy. Fecal occult blood tests have long been used by physicians, in addition to colonoscopy, in an effort to screen for CRC. New screening methods, such as fecal immunochemical test (FIT) and stool DNA (sDNA) testing, have been developed as a more sensitive screening measure to attempt to accurately screen patients who have precancerous or cancerous colorectal lesions. This article compares CRC screening techniques through literature review in order to determine which tests offer the most sensitive detection of CRC and precancerous lesions in average-risk adults over the age of 50 years old. Through this review, it can be seen that sDNA is more sensitive than FIT in detecting all stages of CRC, as well as precancerous lesions.
结直肠癌（CRC）是美国癌症死亡的第三大主要原因。最近，人们更加关注开发有效的筛查工具，以检测结肠和直肠中存在的癌前病变和癌性病变。结肠镜检查已被确立为结肠癌和直肠癌筛查的金标准。然而，由于该检查具有侵入性，并非所有患者都愿意接受结肠镜检查。已开发出非侵入性筛查方法来吸引拒绝接受结肠镜检查的患者。除结肠镜检查外，粪便潜血试验长期以来一直被医生用于筛查结直肠癌。新的筛查方法，如粪便免疫化学试验（FIT）和粪便DNA（sDNA）检测，已被开发出来作为一种更敏感的筛查措施，试图准确筛查患有癌前或癌性结直肠病变的患者。本文通过文献综述比较结直肠癌筛查技术，以确定哪些检测方法能最敏感地检测50岁以上平均风险成年人的结直肠癌和癌前病变。通过这篇综述可以看出，sDNA在检测结直肠癌的所有阶段以及癌前病变方面比FIT更敏感。
