"China colorectal cancer early diagnosis and treatment expert consensus" released! Guide consensus.

Colorectal cancer is a common malignant tumor in China. Its incidence rate is increasing year by year, which seriously endangers people's health.early diagnosis and treatment is the key to improve the prognosis of colorectal cancer patients and reduce the disease burden of the population.the early diagnosis and treatment group of oncology branch of Chinese Medical Association has reached some expert consensus on early screening and diagnosis of colorectal cancer, endoscopic / surgical treatment of early colorectal cancer, adjuvant treatment and remedial measures, and finally formed the expert consensus on early diagnosis and early treatment of colorectal cancer in China.recommended screening method A. immunochemical fecal occult blood test, the recommended screening cycle is once a year; B. multi target fecal detection, the recommended screening cycle is once a year or three years; C. colonoscopy is recommended for standardized ileocecal examination.the general population screening program is recommended a. the screening objects are the general population aged 40-74.B. recommended protocol: Colonoscopy is recommended every 5-10 years; if the screening object refuses to accept colonoscopy directly, the questionnaire risk assessment (Table 1) and fit are used for primary screening, and colonoscopy is performed for those with positive screening (high-risk population or fit positive).if the compliance of screening objects is poor, multi-target fecal DNA test can be carried out for patients with positive screening or those who refuse to be screened, and colonoscopy is recommended for those who are positive. Standardized total colonoscopy is recommended for opportunistic screening.high risk population screening program recommended A. if two first-degree relatives of the screening object are diagnosed with colorectal cancer or progressive adenoma (or one first-degree relative is diagnosed at the age of & lt; 60), it is recommended that colonoscopy should be performed every 5 years starting from the age of 40 or 10 years earlier than the age at which colorectal cancer was first diagnosed in the family.B. for patients with adenomatous polyps syndrome or carriers of pathogenic mutations, a total colonoscopy should be performed once a year. For patients with Lynch syndrome with pathogenic mutations, it is recommended to take colonoscopy from the age of 20-25 years, once every 2 years, until the age of 40, and then once a year.endoscopic diagnosis of early tumor is recommended A. high quality colonoscopy is recommended. Intestinal preparation should be carried out by experienced endoscopists with systematic training to ensure the inspection time and tumor detection rate.B. the suggestion of endoscopic classification of early colorectal cancer can refer to Paris classification standard.if possible, it is recommended to further observe the suspicious lesions with electronic staining endoscopy or magnifying endoscopy.C. for the treatment of flat lesions under endoscopy, it is recommended to resect the lesions as a whole (EMR / ESD) and submit them for examination.surgical treatment of early colorectal tumors is recommended. For early tumors that are beyond the scope of endoscopic resection as indicated by preoperative evaluation and patients who need additional surgery after endoscopic resection, it is recommended to determine the specific surgical method and resection scope based on the comprehensive consideration of tumor growth location, size, patient's surgical tolerance and patient's willingness.early detection of postoperative recurrence of colorectal cancer is recommended. For colorectal cancer patients without residual tumor after treatment, the follow-up contents include: medical history, physical examination, tumor indicators, imaging examination and colonoscopy.the above contents are extracted from the early diagnosis and early treatment group of oncology branch, Chinese Medical Association. Expert consensus on early diagnosis and treatment of colorectal cancer in China [J]. Chinese Journal of medicine, 2020100 (22): 1691-1698