Linda Morrow, DNP, MSN, MBA, NE-BC, CPHQ, CNOR, RN, is Program Director, Nursing Management and Executive Leadership, Clinical Associate Professor of Nursing, Dr. Susan L. Davis & Richard J. Henley College of Nursing, Sacred Heart University, Fairfield, Connecticut.
Beverly Greenwald, PhD, MSN, APRN, FNP-BC, NP-C, CGRN, RN, is Professor of Nursing, Department of Nursing, Archer College of Health and Human Services, Angelo State University, San Angelo, Texas.
Gastroenterol Nurs. 2022;45(3):184-187. doi: 10.1097/SGA.0000000000000638. Epub 2022 Feb 28.
Colorectal cancer ranks third for both men and women as the most common cause of cancer death in the United States. Screening allows for removal of polyps before they turn to cancer or by identifying early-stage colorectal cancers, which are most treatable. The American College of Gastroenterology recently released an update of their 2009 recommendations, which includes average risk individuals between ages 45 and 49 years due to the increased incidence of early-onset colorectal cancers. They consider screening two types of screening options: (1) one-step colonoscopy, which is both diagnostic and therapeutic and (2) two-step options, all of which require a follow-up colonoscopy when the first step is positive. They added the recommendation of daily aspirin for some people aged 50 to 69 years. However, the recommendations for screening remain the same when people do take aspirin. They recommend endoscopists measure cecal intubation rates, adenoma detection rates, and withdrawal times to reduce postcolonoscopy cancers due to missed lesions. They also propose strategies to promote screening adherence and suggest health systems adopt them. These are important updates of which the gastroenterology nurse should be aware and assist with their implementation.
在美国，结直肠癌在男性和女性中均排名第三，是癌症死亡的最常见原因。筛查可以在息肉癌变之前将其切除，或者通过早期发现结直肠癌来进行治疗，因为早期结直肠癌最容易治疗。美国胃肠病学学院最近更新了其 2009 年的建议，将年龄在 45 岁至 49 岁之间的普通风险人群纳入其中，这是因为早发性结直肠癌的发病率增加。他们考虑了两种筛查选择：（1）一步结肠镜检查，兼具诊断和治疗功能；（2）两步选择，所有这些选择在第一步阳性时都需要进行后续结肠镜检查。他们还增加了建议一些 50 岁至 69 岁的人每天服用阿司匹林。然而，当人们服用阿司匹林时，筛查建议仍然保持不变。他们建议内镜医生测量盲肠插管率、腺瘤检出率和退出时间，以减少因遗漏病变而导致的结肠镜检查后癌症。他们还提出了促进筛查依从性的策略，并建议卫生系统采用这些策略。这些都是重要的更新，胃肠病学护士应该了解并协助实施。
