Hissong Erika, Pittman Meredith E
Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York City, NY, USA.
Crit Rev Clin Lab Sci. 2020 Jan;57(1):22-36. doi: 10.1080/10408363.2019.1670614. Epub 2019 Oct 11.
Colorectal carcinoma screening programs have shown success in lowering both the incidence and mortality rate of colorectal carcinoma at a population level, in part because this carcinoma is relatively slow growing and has an identifiable premalignant lesion. Still, many patients do not undergo the recommended screening for colorectal carcinoma, and of those who do, a subset may be over- or under-diagnosed by the currently available testing methods. The primary purpose of this article is to review the data regarding currently available colorectal cancer screening modalities, which include fecal occult blood testing, direct colonic visualization, and noninvasive imaging techniques. In addition, readers will be introduced to a variety of biomarkers that may serve as stand-alone or adjunct tests in the future. Finally, there is a brief discussion of the current epidemiologic considerations that public health officials must address as they create population screening guidelines. The data we provide as laboratory physicians and scientists are critical to the construction of appropriate recommendations that ultimately decrease the burden of disease from colorectal carcinoma.
结直肠癌筛查项目已在降低人群层面的结直肠癌发病率和死亡率方面取得成功，部分原因在于这种癌症生长相对缓慢且有可识别的癌前病变。然而，许多患者并未接受推荐的结直肠癌筛查，而在接受筛查的患者中，一部分可能会被目前可用的检测方法过度诊断或诊断不足。本文的主要目的是回顾有关目前可用的结直肠癌筛查方式的数据，这些方式包括粪便潜血试验、直接结肠可视化和非侵入性成像技术。此外，还将向读者介绍各种未来可能作为独立检测或辅助检测的生物标志物。最后，简要讨论了公共卫生官员在制定人群筛查指南时必须考虑的当前流行病学因素。我们作为实验室医生和科学家提供的数据对于构建适当的建议至关重要，这些建议最终将减轻结直肠癌的疾病负担。
