Maida Marcello, Macaluso Fabio Salvatore, Ianiro Gianluca, Mangiola Francesca, Sinagra Emanuele, Hold Georgina, Maida Carlo, Cammarota Giovanni, Gasbarrini Antonio, Scarpulla Giuseppe
a Section of Gastroenterology , S.Elia - Raimondi Hospital , Caltanissetta , Italy.
b Section of Internal Medicine , Villa Sofia - V. Cervello Hospital , Palermo , Italy.
Expert Rev Anticancer Ther. 2017 Dec;17(12):1131-1146. doi: 10.1080/14737140.2017.1392243. Epub 2017 Oct 26.
Colorectal cancer (CRC) is the third most common cancer in males and second in females, and the fourth most common cause of cancer death worldwide. Currently, about 60-70% of diagnosed cases in symptomatic patients are detected at an advanced stage of disease. Earlier stage detection through the use of screening strategies would allow for better outcomes in terms of reducing the disease burden. Areas covered: The aim of this paper is to review the current published evidence from literature which assesses the performance and effectiveness of different screening tests for the early detection of CRC. Expert commentary: Adequate screening strategies can reduce CRC incidence and mortality. In the last few decades, several tests have been proposed for CRC screening. To date, there is still insufficient evidence to identify which approach is definitively superior, and no screening strategy for CRC can therefore be defined as universally ideal. The best strategy would be the one that can be economically viable and to which the patient can adhere best to over time. The latest guidelines suggest colonoscopy every 10 years or annual fecal immuno-chemical test (FIT) for people with normal risk, while for individuals with high risk or hereditary syndromes specific recommendations are provided.
结直肠癌（CRC）是男性中第三大常见癌症，女性中第二大常见癌症，也是全球第四大常见癌症死亡原因。目前，有症状患者中约60 - 70%的确诊病例是在疾病晚期被发现的。通过使用筛查策略进行早期检测，在减轻疾病负担方面将带来更好的结果。涵盖领域：本文旨在回顾目前已发表的文献证据，这些证据评估了不同筛查测试对早期检测结直肠癌的性能和有效性。专家评论：适当的筛查策略可以降低结直肠癌的发病率和死亡率。在过去几十年中，已经提出了几种用于结直肠癌筛查的测试。迄今为止，仍然没有足够的证据来确定哪种方法绝对更优，因此没有一种结直肠癌筛查策略可以被定义为普遍理想的。最佳策略将是那种在经济上可行且患者能够长期最佳依从的策略。最新指南建议，风险正常的人群每10年进行一次结肠镜检查或每年进行一次粪便免疫化学检测（FIT），而对于高风险或遗传性综合征个体，则提供了具体建议。
