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沙特阿拉伯的结直肠癌作为在医疗保健中实施预测、预防和个性化医疗策略的原理验证模型。

Colorectal cancer in Saudi Arabia as the proof-of-principle model for implementing strategies of predictive, preventive, and personalized medicine in healthcare.

作者信息

Alyabsi Mesnad, Alhumaid Abdulrahman, Allah-Bakhsh Haafiz, Alkelya Mohammed, Aziz Mohammad Azhar

机构信息

1Population Health Research Section, King Abdullah International Medical Research Center, P.O. Box 22490, Riyadh, 11426 Saudi Arabia.

2King Saud bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426 Saudi Arabia.

出版信息

EPMA J. 2019 Aug 31;11(1):119-131. doi: 10.1007/s13167-019-00186-x. eCollection 2020 Mar.

Abstract

Colorectal cancer (CRC) is the most commonly diagnosed cancer among Saudi males and ranks third in females with up to 73% of cases diagnosed at late stage. This review provides an analysis of CRC situation in the Kingdom of Saudi Arabia (KSA) from healthcare perspective. A PUBMED (1986-2018) search was done to identify publications focusing on CRC in KSA. Due to reports of increased CRC incidence among young age group (< 50), and given the young population of KSA, the disease may burden the national healthcare system in the next decades. Environmental factors attributed to increasing incidence rates of CRC include red meat consumption, sedentary lifestyle, and increased calorie intake. Despite substantial investment in healthcare, attention to predictive diagnostics and targeted prevention is lacking. There is a need to develop national screening guidelines based on evidence that supports a reduction in incidence and mortality of CRC when screening is implemented. Future approaches are discussed based on multi-level diagnostics, risk assessment, and population screening programs focused on the needs of young populations that among others present the contents of the advanced approach by predictive, preventive, and personalized medicine. Recommendations are provided that could help to develop policies at regional and national levels. Countries with demographics and lifestyle similar to KSA may gain insights from this review to shape their policies and procedures.

摘要

结直肠癌(CRC)是沙特男性中最常被诊断出的癌症,在女性中排名第三,高达73%的病例在晚期被诊断出来。本综述从医疗保健角度对沙特阿拉伯王国(KSA)的结直肠癌情况进行了分析。通过对PUBMED(1986 - 2018年)进行检索,以确定关注沙特阿拉伯结直肠癌的出版物。由于有报告称年轻年龄组(<50岁)的结直肠癌发病率上升,且沙特阿拉伯人口年轻化,未来几十年该疾病可能会给国家医疗保健系统带来负担。导致结直肠癌发病率上升的环境因素包括红肉消费、久坐不动的生活方式以及热量摄入增加。尽管在医疗保健方面投入巨大,但对预测性诊断和针对性预防的关注仍显不足。有必要基于证据制定国家筛查指南,以支持在实施筛查时降低结直肠癌的发病率和死亡率。本文讨论了未来基于多层次诊断、风险评估以及针对年轻人群需求的人群筛查计划的方法,其中介绍了预测性、预防性和个性化医学的先进方法的内容。文中还提供了有助于在地区和国家层面制定政策的建议。人口统计学和生活方式与沙特阿拉伯类似的国家可能会从本综述中获得见解,以制定其政策和程序。

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