ACG Clinical Guidelines: Colorectal Cancer Screening 2021
ACG Clinical Guidelines: Colorectal Cancer Screening 2021
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DOI：
10.14309/ajg.0000000000001122
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发表时间：
2021-03-01
影响因子：
9.8
通讯作者：
Rex, Douglas K.
中科院分区：
文献类型：
--
作者：
Shaukat, Aasma;Kahi, Charles J.;Rex, Douglas K.
结直肠癌（CRC）是美国男性和女性中第三大常见癌症。CRC筛查的目的是切除腺瘤和无底锯齿状病变，并检测早期CRC。本文的目的是更新2009年美国胃肠学会CRC筛查指南。该指导方针围绕几个关键问题展开。我们进行了全面的文献检索，包括截至2020年10月的研究。纳入标准是年龄在40岁及以上的男性和女性的任何设计的研究。对一般风险个体和有CRC家族史的人进行CRC筛查的详细建议进行了讨论。我们还就阿司匹林在化学预防中的作用、结肠镜检查的质量指标、有组织的结直肠癌筛查方法和提高结直肠癌筛查的依从性提供了建议。必须优化CRC筛查，以有效和持续地降低CRC发病率和死亡率。这可以通过实现高依从率、质量监测和改进、遵循循证指南以及通过从无创筛查试验到筛查和诊断结肠镜检查的一系列护理消除障碍来实现。开发具有成本效益的、高度准确的、无创的模式，并提高筛查过程的整体依从性也是一个理想的目标。
Colorectal cancer (CRC) is the third most common cancer in men and women in the United States. CRC screening efforts are directed toward removal of adenomas and sessile serrated lesions and detection of early-stage CRC. The purpose of this article is to update the 2009 American College of Gastroenterology CRC screening guidelines. The guideline is framed around several key questions. We conducted a comprehensive literature search to include studies through October 2020. The inclusion criteria were studies of any design with men and women age 40 years and older. Detailed recommendations for CRC screening in average-risk individuals and those with a family history of CRC are discussed. We also provide recommendations on the role of aspirin for chemoprevention, quality indicators for colonoscopy, approaches to organized CRC screening and improving adherence to CRC screening. CRC screening must be optimized to allow effective and sustained reduction of CRC incidence and mortality. This can be accomplished by achieving high rates of adherence, quality monitoring and improvement, following evidence-based guidelines, and removing barriers through the spectrum of care from noninvasive screening tests to screening and diagnostic colonoscopy. The development of cost-effective, highly accurate, noninvasive modalities associated with improved overall adherence to the screening process is also a desirable goal.