Iyad A Issa, Malak Noureddine, Department of Gastroenterology and Hepatology, Rafik Hariri University Hospital, Jnah, 33967 Beirut, Lebanon.
World J Gastroenterol. 2017 Jul 28;23(28):5086-5096. doi: 10.3748/wjg.v23.i28.5086.
Colorectal cancer (CRC) is a significant cause of morbidity and mortality worldwide. However, colon cancer incidence and mortality is declining over the past decade owing to adoption of effective screening programs. Nevertheless, in some parts of the world, CRC incidence and mortality remain on the rise, likely due to factors including "westernized" diet, lifestyle, and lack of health-care infrastructure and resources. Participation and adherence to different national screening programs remain obstacles limiting the achievement of screening goals. Different modalities are available ranging from stool based tests to radiology and endoscopy with varying sensitivity and specificity. However, the availability of these tests is limited to areas with high economic resources. Recently, FDA approved a blood-based test (Epi procolon) for CRC screening. This blood based test may serve to increase the participation and adherence rates. Hence, leading to increase in colon cancer detection and prevention. This article will discuss various CRC screening tests with a particular focus on the data regarding the new approved blood test. Finally, we will propose an algorithm for a simple cost-effective CRC screening program.
结直肠癌(CRC)是全球发病率和死亡率的主要原因。然而,由于采用了有效的筛查计划,在过去十年中结肠癌的发病率和死亡率呈下降趋势。尽管如此,在世界某些地区,CRC 的发病率和死亡率仍在上升,这可能是由于“西化”的饮食、生活方式以及缺乏医疗保健基础设施和资源等因素造成的。参与和遵守不同的国家筛查计划仍然是限制实现筛查目标的障碍。有多种方法可供选择,范围从基于粪便的检测到放射学和内窥镜检查,其敏感性和特异性各不相同。然而,这些检测的可用性仅限于经济资源丰富的地区。最近,美国食品和药物管理局(FDA)批准了一种用于 CRC 筛查的基于血液的检测(Epi procolon)。这种基于血液的检测可能有助于提高参与率和依从率。因此,这将导致结肠癌的检出率和预防率提高。本文将讨论各种 CRC 筛查检测方法,特别关注新批准的血液检测数据。最后,我们将提出一个简单、具有成本效益的 CRC 筛查计划算法。