超出范围:结肠癌筛查测试的最新进展。

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Timothy Yen, Minh Do, Swati G Patel
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引用次数: 0

摘要

综述目的:结直肠癌(CRC)在50岁以下人群中很常见且呈上升趋势,但筛查的接受程度并不理想,特别是在45-49岁的人群中。通过发现和切除晚期癌前结直肠癌病变(apl)或早期发现结直肠癌,可以预防结直肠癌的死亡。在这篇综述中,我们涵盖了平均风险的CRC筛查选择,并提出了在不同临床环境中选择测试的框架。最新发现:最佳的CRC筛查试验应该对api和早期CRC高度敏感,易于获得,患者和付款人都负担得起,并且适合筛查设置。有组织的筛查是在人群水平上系统地进行的,而机会性筛查依赖于个体提供者-患者共同决策。除了现有的选择,如粪便免疫化学检测、多靶点粪便DNA检测和结肠镜检查外,新的选择包括基于粪便的RNA检测、下一代基于粪便的DNA检测和基于血液的DNA检测。尽管基于血液的检查可能很方便,但其对api的低敏感性可能无意中导致对CRC预防的负面影响。摘要:现有的和新型的CRC筛查试验的吸收、成本和有效性影响了特定筛查设置的选择方式。结肠镜检查和粪便检查通常应作为CRC筛查的第一线。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Beyond the scope: an update on colon cancer screening tests.

Purpose of review: Colorectal cancer (CRC) is common and rising among persons under age 50, but screening uptake is sub-optimal, particularly in 45-49 year-olds. Death from CRC can be prevented through detection and removal of advanced precancerous colorectal lesions (APLS) or detection of CRC at an early stage. In this review, we cover average-risk CRC screening options and present a framework for test selection in different clinical settings.

Recent findings: The optimal CRC screening test should be highly sensitive for APLs and early stage CRC, easy to access, affordable to patient and payers, and appropriate for screening settings. Organized screening is administered systematically on the population-level, while opportunistic screening relies on individual provider-patient shared decision making. In addition to established options such as fecal immunochemical testing, multitarget stool DNA testing, and colonoscopy, novel options include stool-based RNA testing, next-generation stool-based DNA testing, and blood-based DNA testing. Although blood-based tests may be convenient, their low sensitivity for APLs can unintentionally lead to negative consequences for CRC prevention.

Summary: Uptake, cost, and efficacy of established and novel CRC screening tests influence the modality of choice for specific screening settings. Colonoscopy and stool-based tests should generally be first-line for CRC screening.

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来源期刊
Current Opinion in Gastroenterology
Current Opinion in Gastroenterology 医学-胃肠肝病学
CiteScore
5.30
自引率
0.00%
发文量
137
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.
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