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Examen de detección para el cáncer colorrectal: Declaración de recomendación del grupo de trabajo de servicios

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El cribado del cáncer colorrectal ofrece beneficios sustanciales para los adultos de 50 a 75 años y beneficios moderados para los de 45 a 49 años. El cribado selectivo puede beneficiar a los adultos de 76 a 85 años que hayan sido previamente examinados.

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Área de la Ciencia:

  • La medicina preventiva
  • En el campo de la oncología
  • Salud pública

Sus antecedentes:

  • El cáncer colorrectal (CRC) es una de las principales causas de muerte por cáncer en los Estados Unidos, con una incidencia creciente en adultos más jóvenes.
  • Un porcentaje significativo de adultos elegibles no está al día con el cribado de CCR.
  • El Grupo de Trabajo de Servicios Preventivos de los Estados Unidos (USPSTF, por sus siglas en inglés) actualizó sus recomendaciones de detección del CRC.

Objetivo del estudio:

  • Evaluar los beneficios y los daños de la detección de CCR en adultos de 40 años o más.
  • Examinar las variaciones en la eficacia del cribado según la edad, el sexo y la raza/etnia.
  • Proporcionar datos de modelado sobre los años de vida ganados y los casos/muertes de CCR evitados mediante diferentes estrategias de detección.

Principales métodos:

  • Revisión sistemática de la evidencia sobre las ventajas y los inconvenientes del cribado de CCR.
  • Modelado comparativo por la Red de Intervención y Vigilancia de Modelado del Cáncer (CISNET) Grupo de Trabajo de Cáncer Colorectal.
  • Análisis de las estrategias de cribado en diferentes edades de inicio y finalización.

Principales resultados:

  • Alta certeza de beneficio neto sustancial para el cribado de CRC en adultos de 50 a 75 años.
  • Certeza moderada de beneficio neto moderado para el cribado de CRC en adultos de 45 a 49 años.
  • Pequeño beneficio neto para los adultos de 76 a 85 años previamente examinados; es más probable que los individuos nunca examinados se beneficien.

Conclusiones:

  • USPSTF recomienda el cribado de CRC para todos los adultos de 50 a 75 años (recomendación A).
  • La USPSTF recomienda el cribado de CRC para adultos de 45 a 49 años (recomendación B).
  • USPSTF recomienda el cribado selectivo para adultos de 76 a 85 años, teniendo en cuenta la salud individual y el historial (recomendación C).