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结直肠癌的筛查与预防。

Screening and prevention of colorectal cancer.

机构信息

Division of Gastroenterology, University of Utah, Salt Lake City, UT, USA

Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.

出版信息

BMJ. 2021 Sep 15;374:n1855. doi: 10.1136/bmj.n1855.

Abstract

Mortality from colorectal cancer is reduced through screening and early detection; moreover, removal of neoplastic lesions can reduce cancer incidence. While understanding of the risk factors, pathogenesis, and precursor lesions of colorectal cancer has advanced, the cause of the recent increase in cancer among young adults is largely unknown. Multiple invasive, semi- and non-invasive screening modalities have emerged over the past decade. The current emphasis on quality of colonoscopy has improved the effectiveness of screening and prevention, and the role of new technologies in detection of neoplasia, such as artificial intelligence, is rapidly emerging. The overall screening rates in the US, however, are suboptimal, and few interventions have been shown to increase screening uptake. This review provides an overview of colorectal cancer, the current status of screening efforts, and the tools available to reduce mortality from colorectal cancer.

摘要

结直肠癌的死亡率可以通过筛查和早期发现来降低;此外,切除肿瘤病变可以降低癌症的发病率。尽管人们对结直肠癌的危险因素、发病机制和癌前病变有了更多的了解,但近年来年轻人癌症发病率上升的原因在很大程度上仍不清楚。过去十年中出现了多种侵袭性、半侵袭性和非侵袭性的筛查方法。目前对结肠镜检查质量的重视提高了筛查和预防的效果,人工智能等新技术在检测肿瘤方面的作用也迅速显现。然而,美国的总体筛查率并不理想,而且很少有干预措施被证明可以提高筛查率。本文综述了结直肠癌的发病情况、目前的筛查现状以及降低结直肠癌死亡率的可用工具。

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