University of Colorado Anschutz Medical Center, Aurora, Colorado, USA; Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.
Division of Gastroenterology, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA; Vatche and Tamar Manoukian Division of Digestive Diseases and Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Gastrointest Endosc. 2022 Jan;95(1):1-15. doi: 10.1016/j.gie.2021.06.012. Epub 2021 Nov 15.
This document is a focused update to the 2017 colorectal cancer (CRC) screening recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer, which represents the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy. This update is restricted to addressing the age to start and stop CRC screening in average-risk individuals and the recommended screening modalities. Although there is no literature demonstrating that CRC screening in individuals under age 50 improves health outcomes such as CRC incidence or CRC-related mortality, sufficient data support the U.S. Multi-Society Task Force to suggest average-risk CRC screening begin at age 45. This recommendation is based on the increasing disease burden among individuals under age 50, emerging data that the prevalence of advanced colorectal neoplasia in individuals ages 45 to 49 approaches rates in individuals 50 to 59, and modeling studies that demonstrate the benefits of screening outweigh the potential harms and costs. For individuals ages 76 to 85, the decision to start or continue screening should be individualized and based on prior screening history, life expectancy, CRC risk, and personal preference. Screening is not recommended after age 85.
本文件是对美国多学会大肠癌工作组 2017 年大肠癌（CRC）筛查建议的重点更新，该工作组代表美国胃肠病学会、美国胃肠病协会和美国胃肠内镜学会。本次更新仅限于解决一般风险人群中开始和停止 CRC 筛查的年龄以及推荐的筛查方式。虽然没有文献表明在 50 岁以下人群中进行 CRC 筛查可以改善 CRC 发病率或 CRC 相关死亡率等健康结果，但足够的数据支持美国多学会大肠癌工作组建议一般风险 CRC 筛查的起始年龄为 45 岁。这一建议是基于以下原因：50 岁以下人群的疾病负担不断增加；有数据表明，45 岁至 49 岁人群中晚期结直肠肿瘤的患病率接近 50 岁至 59 岁人群的患病率；建模研究表明，筛查的益处超过了潜在的危害和成本。对于 76 岁至 85 岁的人群，开始或继续筛查的决定应根据既往筛查史、预期寿命、CRC 风险和个人偏好进行个体化。85 岁以后不建议进行筛查。
