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首页> 外文期刊>Digestive Diseases and Sciences >Practical Opportunities to Improve Early Detection and Prevention of Colorectal Cancer (CRC) in Members of High-Risk Families
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Practical Opportunities to Improve Early Detection and Prevention of Colorectal Cancer (CRC) in Members of High-Risk Families

机译：改善高危家庭成员大肠癌（CRC）的早期发现和预防的实际机会

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摘要

Colorectal cancer (CRC) incidence and mortality are steadily declining and CRC screening rates are increasing in the United States. Although this a very good news, several definable groups still have very low screening rates including younger (under age 50) members of high-risk CRC families. This opinion piece describes five strategies that could be incorporated into routine practice to improve identification and guideline-based screening in members of high-risk families. Routine incorporation of a simple family history screening tool and outreach to high-risk family members could substantially improve guideline-based screening in this population. Identification of CRCs and advanced adenomas in the endoscopy suite defines another group of high-risk families for similar outreach. Lynch syndrome families can be identified by testing CRCs and selected adenomas for microsatellite instability or loss of DNA repair protein expression. Finally, selective addition of aspirin to surveillance endoscopy can decrease the risk of new adenomas and CRCs. The rationale for these strategies as well as mechanisms for their implementation and evaluation in clinical practice is described.
机译：在美国，结直肠癌（CRC）的发生率和死亡率一直在下降，CRC筛查率也在上升。尽管这是一个好消息，但仍有几个明确的人群筛查率仍然很低，其中包括高风险的CRC家庭的年轻成员（50岁以下）。本意见片描述了五种策略，可以将这些策略纳入常规实践，以改善高危家庭成员的识别和基于指南的筛查。常规纳入简单的家族史筛查工具并与高危家庭成员进行接触可以大大改善该人群基于指南的筛查。在内窥镜检查套件中对CRC和晚期腺瘤的鉴定定义了另一组高风险家庭，具有类似的服务范围。 Lynch综合征家族可以通过测试CRC和选择的腺瘤来确定微卫星不稳定性或DNA修复蛋白表达的丧失。最后，在监测内镜中选择性添加阿司匹林可以降低发生新的腺瘤和CRC的风险。描述了这些策略的原理以及在临床实践中其实施和评估的机制。

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