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结直肠癌:筛查策略的演变

Colorectal cancer: evolution of screening strategies.

作者信息

Sur Daniel, Colceriu Marius, Sur Genel, Floca Emanuela, Dascal Loredana, Irimie Alexandru

机构信息

Medical Oncology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

2 Pediatrics Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

出版信息

Med Pharm Rep. 2019 Jan;92(1):21-24. doi: 10.15386/cjmed-1104. Epub 2019 Jan 15.

Abstract

BACKGROUND AND AIM

Colorectal cancer is considered to be a major public health problem. It is the third most frequent cancer at a global level and also the fourth most frequent cause of death. Previous scientific findings have proved that a significant percentage of colorectal cancer deaths are due to the abscence of screening. The aim of this review is to present the evolution of the screening strategies by using the most recommended and recent colorectal cancer screening guidelines.

METHODS

A systematic literature search on the scientific databases was performed, identifying some of the most important colorectal cancer screening guidelines publications.

RESULTS

The most recent guidelines of American Cancer Society (2018) recommend that adults aged 45 years and older with an average risk of colorectal cancer should undergo regular screening. All the guidelines have considered fecal occult blood testing (annual or biennial), fecal immunochemical test (annual), flexible sigmoidoscopy (every 5 years) and colonoscopy (every 10 years) as the most preferred screening options. However, there are discrepancies with regards to which tests should be preferred for screening.

CONCLUSION

Increased compliance with colorectal cancer screening recommendations has the potential to improve patients' health and to reduce colorectal cancer morbidity and mortality rates. It is important for health care providers to have an understanding of the risk factors for colorectal cancer and various stages of disease development in order to recommend appropriate screening strategies.

摘要

背景与目的

结直肠癌被视为一个重大的公共卫生问题。它是全球第三大常见癌症,也是第四大常见死因。先前的科学研究结果证明,相当一部分结直肠癌死亡是由于缺乏筛查。本综述的目的是利用最推荐且最新的结直肠癌筛查指南来呈现筛查策略的演变。

方法

在科学数据库中进行了系统的文献检索,确定了一些最重要的结直肠癌筛查指南出版物。

结果

美国癌症协会(2018年)的最新指南建议,45岁及以上患结直肠癌平均风险的成年人应接受定期筛查。所有指南都将粪便潜血试验(每年或每两年一次)、粪便免疫化学试验(每年一次)、乙状结肠镜检查(每5年一次)和结肠镜检查(每10年一次)视为最优选的筛查选项。然而,对于哪种检查应优先用于筛查存在差异。

结论

提高对结直肠癌筛查建议的依从性有可能改善患者健康并降低结直肠癌的发病率和死亡率。医疗保健提供者了解结直肠癌的危险因素和疾病发展的各个阶段,以便推荐合适的筛查策略非常重要。

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Colorectal cancer: evolution of screening strategies.结直肠癌:筛查策略的演变
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Cancer statistics, 2018.癌症统计数据,2018 年。
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Colorectal cancer development and advances in screening.结直肠癌的发展与筛查进展
Clin Interv Aging. 2016 Jul 19;11:967-76. doi: 10.2147/CIA.S109285. eCollection 2016.
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Worldwide burden of colorectal cancer: a review.全球结直肠癌负担:综述
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