Can we achieve an 80% screening rate for colorectal cancer by 2018 in the United States?
Can we achieve an 80% screening rate for colorectal cancer by 2018 in the United States?
复制标题
%20我们%20能否在%20%20美国%20州实现%20an%2080%%20针对%20结直肠%20癌症%20by%202018%20的%20筛查%20率%20？
作者：
Paskett,ElectraD;Khuri,FadloR
In this issue of Cancer, Meester et al1 have predicted that approximately 280,000 new cases of colorectal cancer (CRC) and 200,000 CRC deaths could be averted by 2030 if CRC screening rates increased from the current National Health Interview Survey rate of 58%(self-reported) to 80% by 2018. From a public health perspective, the impact of such an increase would no doubt be large: 16,500 fewer cases of CRC per year (a 12% reduction in the number of cases) and 12,000 fewer deaths from CRC per year (a 24% reduction in the number of deaths). 2 The bigger question is how do we, as a nation, reach 80% adherence to CRC screening?Current self-reported CRC screening rates in the National Health Interview Survey are at 58%. 3 This is self-reported, however, and true screening rates are most likely< 50% for adults aged≥ 50 years. 4 Therefore, one challenge is ensuring accurate, via medical record, accounting of real, state-of-the art CRC screening. A consistent national standard of what constitutes state-of-the-art CRC screening needs to be clarified to physicians, patients, and insurers. 5 Colonoscopy is the most preferred method of screening, because any polyps found can easily be removed in the same procedure, and the entire colon is visualized. 6 Colonoscopy has been validated in a randomized trial to have a mortality benefit. 7 However, not everyone can tolerate a colonoscopy, has access to colonoscopy services, or can afford any copayments. Thus, other modalities (eg, fecal occult blood test, fecal immunochemical test, and flexible sigmoidoscopy) can also be of benefit, and their efficacy has also been established in randomized controlled trials. 8-11 Guidelines established by the American College of Physicians regarding the suggested frequency by risk status should be followed. 5
