对结肠直肠癌的查:美国预防服务工作组建议声明
, Kirsten Bibbins-Domingo1, David C Grossman2
1University of California, San Francisco.
JAMA
|June 16, 2016
概括
对于50至75岁的成年人来说,定期进行结肠直肠癌查有很大的好处. 有多种查方法,但没有一种方法被证明能降低癌症发病率和死亡率.
科学领域:
- 癌症学
- 预防医学
- 公共卫生
背景情况:
- 结肠直肠癌是美国癌症死亡的主要原因,大多数患者年龄在65-74岁之间.
- 预计2016年新增病例约为134,000例,死亡人数为49,000人.
- 结肠直肠癌查是一种未被充分利用的预防健康策略.
研究的目的:
- 更新2008年美国预防服务工作组 (USPSTF) 关于结直肠癌查的建议.
- 审查各种查方法的有效性,危害和试验性能.
主要方法:
- 对查测试的证据进行系统审查,包括结肠镜检查,结肠镜检查,CT结肠镜检查和各种便检查.
- 评估与查测试相关的危害.
- 对最佳查年龄和间隔进行比较建模研究.
主要成果:
- 在50至75岁的无症状成年人中进行结肠直肠癌查,可获得显著的净益.
- 有多种查策略,每种都有不同的证据,优势和局限性.
- 没有经验数据表明某种策略比其他策略带来更大的净收益.
结论:
- 美国公立卫生检查委员会建议对50至75岁的成年人进行结直肠癌查 (A建议).
- 对于76-85岁的成年人,应根据整体健康状况和先前的查史 (C建议) 进行个性化查决定.
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