Brewer D A, Fung C L, Chapuis P H, Bokey E L
Department of Colorectal Surgery, University of Sydney, Concord, New South Wales, Australia.
Dis Colon Rectum. 1994 Dec;37(12):1328-38. doi: 10.1007/BF02257807.
The objective of our investigation was to attempt to address the controversial issue concerning index screening and surveillance of relatives of patients with colorectal cancer and to identify those areas of research that should be considered in future studies.
Relevant literature was reviewed concerning the screening of asymptomatic first-degree relatives of patients with colorectal cancer not associated with the rare autosomal dominant inherited colorectal cancer syndromes.
The data reviewed suggest that there is an increased risk of colorectal neoplasia in this population and a significantly higher yield of adenomas and carcinomas when colonoscopy is used for index screening. However, significant variability in study design and screening protocols and inconsistencies in data presentation make clinical interpretation and data analysis confusing and difficult.
There is a critical need for standardization in future studies. Furthermore, as there are no studies that document decreased overall mortality from colorectal cancer in first-degree relatives as a result of screening, the decision as to whether to screen this population needs to be based on future prospective controlled trials.
我们调查的目的是试图解决有关结直肠癌患者亲属的索引筛查和监测这一有争议的问题，并确定未来研究中应考虑的研究领域。
对有关非罕见常染色体显性遗传性结直肠癌综合征相关的结直肠癌患者无症状一级亲属筛查的相关文献进行了综述。
综述数据表明，该人群患结直肠肿瘤的风险增加，当使用结肠镜检查进行索引筛查时，腺瘤和癌的检出率显著更高。然而，研究设计和筛查方案存在显著差异，数据呈现也不一致，这使得临床解释和数据分析既混乱又困难。
未来研究迫切需要标准化。此外，由于尚无研究记录筛查可降低一级亲属结直肠癌的总体死亡率，因此是否对该人群进行筛查的决定需要基于未来的前瞻性对照试验。
