更新的结肠直肠癌筛查指南：要知道的内容

该U.S. Preventive Services Task Force (USPSTF)released a new draft结肠直肠癌筛查推荐today, lowering the age for average-risk adults to begin screening from 50 to 45. The draft recommendation will undergo further review before it’s finalized, but the lower screening age is consistent with the change the美国癌症学会对他们的结直肠癌筛查指南2018年。

该se changes come in response to scientific studies that show therates of colorectal cancer continue to increaseamong younger adults.

We spoke with ourY. Nancy You, M.D.那to learn more about the new guidelines and what they mean.

Why is it significant that another national organization now recommends lowering the age for colorectal cancer screening?

该美国癌症学会and USPSTF are two of the major groups that set the standard for cancer screenings in the U.S. Patients and doctors look to these national organizations for guidance on cancer screening exams. Insurance providers, including Medicare, use their guidance to determine which screening exams are covered as preventive services.

我认为我们会看到更多的医生推荐较低的年龄和更多45岁的患者，如果两个团体都有一致的关于年龄开始筛查的准则，那么他们的第一个结肠镜检查。

Why do you think they have made this change?

我认为这种变化有几个动机。首先，在过去的几十年中，在年龄18至50岁的年轻成年人中增加结直肠癌率，特别是直肠癌那which are more complicated to treat. There is also strong evidence these trends will continue over time.

Additionally, there is a strong desire and a high level of motivation to reduce premature deaths from colorectal cancer. Almost 70% of colorectal cancers diagnosed below age 50 are already stage III or IV, meaning the cancer has spread to the lymph nodes or beyond. When the disease is diagnosed at earlier stages, currenttreatment optionsare more successful.

更新的推荐如何解决癌症差异，特别是在黑人美国人之间？

Black Americans are more likely to be diagnosed with and die from cancer than other ethnicities. These disparities are found across several of the most common cancer types, including colorectal cancer. While there are many reasons for this,几项研究have identified lower screening rates among Black Americans as an important factor.

该USPSTF has already recommended that Black Americans start colorectal cancer screening at age 45, a younger age than the general population, in an effort to decrease the disparities seen. They have now reinforced this recommendation and extended it to everyone. Lowering the recommended screening age is an important step to help us make an impact on colorectal cancer disparities by finding and treating cancer at earlier stages.

What recommended screening tests are available for colorectal cancer, and how do they differ?

有两种主要类型筛选结直肠癌的试验-- stool-based tests and direct visual exams.

基于粪便的试验包括粪便免疫化学测试（FIT），粪便潜血（FOBT）和粪便DNA测试。这些测试不涉及物理上俯视结肠和直肠，因此它们的侵入性和更便宜的较少。但是，他们需要更频繁地（每1至3年）进行，并且如果发现异常结果，则需要视觉检查来确定恰当是错误的，并建议进行后续行动的过程。

Visual exams, which include thecolonoscopy那virtual colonoscopy(CT colonography) and flexible sigmoidoscopy, involve directly examining the inside of the colon and rectum wherepolypsand other diseases arise. They do involve a certain amount of preparation and an office procedure. They are very safe, but like any procedure, are not risk-free. These are performed less frequently than stool-based tests, generally every 5 to 10 years. If something abnormal were found, further diagnostic or treatment procedures (such as removing a polyp) can be done right away.

What about individuals younger than 45? What should they look out for?

A portion of younger patients with colorectal cancer have a hereditary condition or other medical conditions that increase their risk of this disease. So, it’s important to know your family history and understand associated cancer risks.

Younger adults should also look out forsymptoms that may be consistent with colorectal cancer,如疼痛，出血，改变肠习惯或粪便模式的变化。不要害羞地与你的肠子交谈。

最后，maintain a healthy lifestyle最大限度地减少您的结肠直肠癌风险。健康的生活方式行为包括eating a plant-based diet那getting regular exercise那maintaining a healthy weight, andavoiding tobacco useand excessive alcohol consumption.

在Covid-19大流行期间，人们应该了解与结肠直肠癌筛查的筛查

首先，知道现在安排推荐的癌症筛查是安全的。与许多其他医生的办公室和医院一样，MD Anderson已经实施了广泛的Covid-19协议和预防措施，以保持患者和员工安全。这些应该让你安心地让你的放映时间而不是把它们放在下。重要的是要明白，随时获取放映可以帮助您提前诊断，使我们能够在最早的阶段诊断癌症或癌前诊断，当它们更具可治疗或可固化时。

Also, learn about the different screening tests that are available. Some stool-based tests can be done at home and do not require an office procedure, but a colonoscopy is the gold standard. Remember, if something abnormal were found on a stool-based test, it needs to be followed up with a diagnostic colonoscopy.

在MD Anderson在线预约或通过拨打1-877-632-6789。