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Only for medical professionals to read and reference combined with the latest guidelines to see the screening and monitoring of colorectal cancer
.
Colorectal cancer is the second leading cause of malignant tumor-related deaths in the United States.
In 2021, 150,000 new colorectal cancer patients and 53,000 related deaths will be added.
Among them, 35% of 50-75-year-old patients Have not received any relevant screening
.
In response to this topic, a special report on colorectal cancer screening and monitoring was carried out at the American Digestive Disease Week (DDW)
.
1.
When does colorectal cancer start screening? When will it stop? Professor Oseph Anderson from Dartmouth University in the United States discussed the starting and ending age of colorectal cancer screening according to the current guidelines.
At present, it is believed that: Screening start age: 1.
Comprehensive multi-version guidelines conclude at 45 years; 2.
Still Pending the update of the guidelines of the US Preventive Services Task Force (USPSTF); 3.
If there is a family history of colorectal tumors, it should be taken seriously, and the screening time should be advanced appropriately
.
Screening cut-off age: It should be appropriately adjusted according to comorbidities, risks, symptoms, screening history and personal wishes; and for individuals who have completed colorectal cancer screening before the age of 85, routine screening is not recommended
.
2.
Afraid of colonoscopy? There are also these methods for colorectal cancer screening.
Professor Rachel B.
Issaka from Washington University Cancer Center introduced the currently commonly used non-invasive colorectal cancer screening methods, including: FOBT (Fecal Occult Blood Test, fecal occult blood test) , FIT (fecal immunochemical Test, fecal immunochemical detection), detection of fecal DNA, capsule endoscopy, CT colonography Septin-9 and serum detection
.
However, in screening for colorectal cancer, there are no obvious advantages and disadvantages among the above detection methods
.
A complete non-invasive screening model should include a two-step method.
The first step is to screen out people with positive results on the basis of the above non-invasive methods; the second step is to perform high-level tests for people who have a positive non-invasive test.
Quality colonoscopy
.
FOBT is the earliest application and clinical screening test, but its sensitivity and specificity are low
.
A 30-year clinical result showed that annual FOBT detection can reduce colorectal cancer mortality by 32%, and FOBT detection every other year can reduce colorectal cancer mortality by 22%
.
FIT is the most commonly used non-invasive screening method, its sensitivity and specificity are higher than FOBT, its detection method is simple and easy to implement, can be done at home, so it has high compliance
.
Compared with colonoscopy, FIT can detect 79% of colorectal cancer, while about 94% of normal people are negative
.
During the 6-year follow-up, it was found that FIT screening can reduce the mortality rate of colorectal cancer by about 62%
.
Fecal DNA detection, capsule endoscopy, CT colonography, and serum Septin-9 detection have the characteristics of high price, complicated operation, and low feasibility, which are difficult to be widely carried out in the screening of colorectal cancer
.
Regarding which is the best screening method at present, Professor Rachel B.
Issaka pointed out that the actual consideration should be based on individual factors, regardless of whether good compliance with any one method is the most critical factor that can benefit patients
.
3.
How often will the colorectal polyps be rechecked after resection? Professor Samir Gupta of the University of California, San Diego, then interpreted the 2020 version of the US Multi-Society Taskforce's guidelines for monitoring colorectal cancer after polypectomy
.
The concepts of different types of adenomas are as follows: The 2020 version of the guidelines focuses on updating: 1.
Properly extend the colonoscopy monitoring interval for low-risk adenomas (1-2 adenomas, diameter <10mm) (7-10 years); 2.
For high-risk adenomas, close monitoring and follow-up (colonoscope is monitored every 1-3 years); high-risk adenomas are generally 3 years, and the number of adenomas greater than 10 is one year
.
1.
High attention should be paid to serrated polyps (monitoring colonoscopy at least once every 3 years)
.
The risk of progression to CRC: 1.
There is no significant difference between low-risk adenomas and normal colonoscopy; 2.
The risk of progressive adenomas is significantly increased; 3.
The risk of large serrated adenomas is significantly increased, and the risk of small serrated adenomas Not sure
.
Simplified screening strategy: At this DDW conference, experts focused on the current guidelines for early screening strategies for colorectal cancer and related experience, and emphasized the importance of early screening for colorectal cancer in the diagnosis and treatment of colorectal cancer in the future.
It has important reference significance in the early screening and prevention and control of the country
.
Expert profile Yang Jinlin, deputy director of the Department of Gastroenterology, West China Hospital of Sichuan University, professor/chief physician, doctoral supervisor, and reserve candidate for academic and technical leaders in Sichuan Province, and academic and technical leader in Sichuan Provincial Health Commission.
Currently serving as the Professional Committee of Tumor Endoscopy of Sichuan Anti-Cancer Association Chairman, Deputy Chairman of the Esophageal Cancer Special Committee of Sichuan Oncology Society, Member of the Standing Committee of Sichuan Digestive Branch of Chinese Medical Doctor Association, Member of Sichuan Digestive Endoscopy Branch of Chinese Medical Association, Member of Colonology Group of Digestive Endoscopy Branch of Chinese Medical Association, etc.
Academic appointments
.
Graduated from the former West China Medical University in 1995, and stayed in the hospital after graduation
.
During this period, he went to the City University of New York to study for one year
.
He has long been engaged in medical treatment, teaching, and scientific research of digestive diseases, and is good at solving difficult digestive diseases
.
Establish the largest database of early gastrointestinal cancer and esophageal stents in Sichuan Province
.
Undertake research projects such as global multi-center prospective clinical trials, National Natural Science Foundation of China, provincial science and technology projects, and National Medical Professional Degree Graduate Education Steering Committee; published more than 100 SCI papers and core journal papers as the first author/corresponding author Among them, articles were published in GIE, the top international journal of endoscopy, and Cochrane, the top international journal of evidence-based medicine
.
Participated in 4 invention patents and participated in the editing of 7 books
.
.
Colorectal cancer is the second leading cause of malignant tumor-related deaths in the United States.
In 2021, 150,000 new colorectal cancer patients and 53,000 related deaths will be added.
Among them, 35% of 50-75-year-old patients Have not received any relevant screening
.
In response to this topic, a special report on colorectal cancer screening and monitoring was carried out at the American Digestive Disease Week (DDW)
.
1.
When does colorectal cancer start screening? When will it stop? Professor Oseph Anderson from Dartmouth University in the United States discussed the starting and ending age of colorectal cancer screening according to the current guidelines.
At present, it is believed that: Screening start age: 1.
Comprehensive multi-version guidelines conclude at 45 years; 2.
Still Pending the update of the guidelines of the US Preventive Services Task Force (USPSTF); 3.
If there is a family history of colorectal tumors, it should be taken seriously, and the screening time should be advanced appropriately
.
Screening cut-off age: It should be appropriately adjusted according to comorbidities, risks, symptoms, screening history and personal wishes; and for individuals who have completed colorectal cancer screening before the age of 85, routine screening is not recommended
.
2.
Afraid of colonoscopy? There are also these methods for colorectal cancer screening.
Professor Rachel B.
Issaka from Washington University Cancer Center introduced the currently commonly used non-invasive colorectal cancer screening methods, including: FOBT (Fecal Occult Blood Test, fecal occult blood test) , FIT (fecal immunochemical Test, fecal immunochemical detection), detection of fecal DNA, capsule endoscopy, CT colonography Septin-9 and serum detection
.
However, in screening for colorectal cancer, there are no obvious advantages and disadvantages among the above detection methods
.
A complete non-invasive screening model should include a two-step method.
The first step is to screen out people with positive results on the basis of the above non-invasive methods; the second step is to perform high-level tests for people who have a positive non-invasive test.
Quality colonoscopy
.
FOBT is the earliest application and clinical screening test, but its sensitivity and specificity are low
.
A 30-year clinical result showed that annual FOBT detection can reduce colorectal cancer mortality by 32%, and FOBT detection every other year can reduce colorectal cancer mortality by 22%
.
FIT is the most commonly used non-invasive screening method, its sensitivity and specificity are higher than FOBT, its detection method is simple and easy to implement, can be done at home, so it has high compliance
.
Compared with colonoscopy, FIT can detect 79% of colorectal cancer, while about 94% of normal people are negative
.
During the 6-year follow-up, it was found that FIT screening can reduce the mortality rate of colorectal cancer by about 62%
.
Fecal DNA detection, capsule endoscopy, CT colonography, and serum Septin-9 detection have the characteristics of high price, complicated operation, and low feasibility, which are difficult to be widely carried out in the screening of colorectal cancer
.
Regarding which is the best screening method at present, Professor Rachel B.
Issaka pointed out that the actual consideration should be based on individual factors, regardless of whether good compliance with any one method is the most critical factor that can benefit patients
.
3.
How often will the colorectal polyps be rechecked after resection? Professor Samir Gupta of the University of California, San Diego, then interpreted the 2020 version of the US Multi-Society Taskforce's guidelines for monitoring colorectal cancer after polypectomy
.
The concepts of different types of adenomas are as follows: The 2020 version of the guidelines focuses on updating: 1.
Properly extend the colonoscopy monitoring interval for low-risk adenomas (1-2 adenomas, diameter <10mm) (7-10 years); 2.
For high-risk adenomas, close monitoring and follow-up (colonoscope is monitored every 1-3 years); high-risk adenomas are generally 3 years, and the number of adenomas greater than 10 is one year
.
1.
High attention should be paid to serrated polyps (monitoring colonoscopy at least once every 3 years)
.
The risk of progression to CRC: 1.
There is no significant difference between low-risk adenomas and normal colonoscopy; 2.
The risk of progressive adenomas is significantly increased; 3.
The risk of large serrated adenomas is significantly increased, and the risk of small serrated adenomas Not sure
.
Simplified screening strategy: At this DDW conference, experts focused on the current guidelines for early screening strategies for colorectal cancer and related experience, and emphasized the importance of early screening for colorectal cancer in the diagnosis and treatment of colorectal cancer in the future.
It has important reference significance in the early screening and prevention and control of the country
.
Expert profile Yang Jinlin, deputy director of the Department of Gastroenterology, West China Hospital of Sichuan University, professor/chief physician, doctoral supervisor, and reserve candidate for academic and technical leaders in Sichuan Province, and academic and technical leader in Sichuan Provincial Health Commission.
Currently serving as the Professional Committee of Tumor Endoscopy of Sichuan Anti-Cancer Association Chairman, Deputy Chairman of the Esophageal Cancer Special Committee of Sichuan Oncology Society, Member of the Standing Committee of Sichuan Digestive Branch of Chinese Medical Doctor Association, Member of Sichuan Digestive Endoscopy Branch of Chinese Medical Association, Member of Colonology Group of Digestive Endoscopy Branch of Chinese Medical Association, etc.
Academic appointments
.
Graduated from the former West China Medical University in 1995, and stayed in the hospital after graduation
.
During this period, he went to the City University of New York to study for one year
.
He has long been engaged in medical treatment, teaching, and scientific research of digestive diseases, and is good at solving difficult digestive diseases
.
Establish the largest database of early gastrointestinal cancer and esophageal stents in Sichuan Province
.
Undertake research projects such as global multi-center prospective clinical trials, National Natural Science Foundation of China, provincial science and technology projects, and National Medical Professional Degree Graduate Education Steering Committee; published more than 100 SCI papers and core journal papers as the first author/corresponding author Among them, articles were published in GIE, the top international journal of endoscopy, and Cochrane, the top international journal of evidence-based medicine
.
Participated in 4 invention patents and participated in the editing of 7 books
.
