Department of Medicine, University of Montreal (UdeM), and University of Montreal Hospital Research Center (CRCHUM), Montreal, QC H2X 0A9, Canada.
Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, QC H3G 1A4, Canada.
World J Gastroenterol. 2018 Jan 7;24(1):124-138. doi: 10.3748/wjg.v24.i1.124.
To summarize and compare worldwide colorectal cancer (CRC) screening recommendations in order to identify similarities and disparities.
A systematic literature search was performed using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge identifying all average-risk CRC screening guideline publications within the last ten years and/or position statements published in the last 2 years. In addition, a hand-search of the webpages of National Gastroenterology Society websites, the National Guideline Clearinghouse, the BMJ Clinical Evidence website, Google and Google Scholar was performed.
Fifteen guidelines were identified. Six guidelines were published in North America, four in Europe, four in Asia and one from the World Gastroenterology Organization. The majority of guidelines recommend screening average-risk individuals between ages 50 and 75 using colonoscopy (every 10 years), or flexible sigmoidoscopy (FS, every 5 years) or fecal occult blood test (FOBT, mainly the Fecal Immunochemical Test, annually or biennially). Disparities throughout the different guidelines are found relating to the use of colonoscopy, rank order between test, screening intervals and optimal age ranges for screening.
Average risk individuals between 50 and 75 years should undergo CRC screening. Recommendations for optimal surveillance intervals, preferred tests/test cascade as well as the optimal timing when to start and stop screening differ regionally and should be considered for clinical decision making. Furthermore, local resource availability and patient preferences are important to increase CRC screening uptake, as any screening is better than none.
总结和比较全球结直肠癌（CRC）筛查建议，以发现相似点和差异。
使用 MEDLINE、EMBASE、Scopus、CENTRAL 和 ISI Web of Knowledge 进行系统文献检索，确定过去十年内所有普通风险 CRC 筛查指南出版物和/或过去两年内发布的立场声明。此外，还对手动搜索了国家胃肠病学会网站、国家指南清理中心、BMJ 临床证据网站、Google 和 Google Scholar 的网页。
确定了 15 项指南。其中 6 项指南发表在北美，4 项在欧洲，4 项在亚洲，1 项来自世界胃肠病组织。大多数指南建议对 50 至 75 岁的普通风险个体进行筛查，使用结肠镜检查（每 10 年一次）、柔性乙状结肠镜检查（FS，每 5 年一次）或粪便潜血试验（FOBT，主要是粪便免疫化学试验，每年或每两年一次）。在不同的指南中发现了差异，涉及结肠镜检查的使用、测试的等级顺序、筛查间隔和筛查的最佳年龄范围。
50 至 75 岁的普通风险个体应进行 CRC 筛查。关于最佳监测间隔、首选测试/测试级联以及开始和停止筛查的最佳时间的建议因地区而异，应考虑用于临床决策。此外，当地资源的可用性和患者的偏好对于提高 CRC 筛查的参与度很重要，因为任何筛查都比没有筛查要好。
