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Colorectal Cancer Screening and Prevention in Women

机译：女性大肠癌的筛查与预防

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Colorectal cancer (CRC) is one of the leading cancers and cause of cancer deaths in American women and men. Females and males share a similar lifetime cumulative risk of CRC however, substantial differences in risk factors, tumor biology, and effectiveness of cancer prevention services have been observed between them. This review distills the evidence documenting the unique variation observed between the genders relating to CRC risk factors, screening and prevention. Consistent evidence throughout the world demonstrates that women reach equivalent levels of adenomas and CRC as men but it occurs nearly a decade later in life than in their male counterparts. Women have a higher proportion of tumors which are hypermethylated, have microsatellite instability and located in the proximal colon suggesting the serrated pathway may be of greater consequence in them than in men. Other CRC risk factors such as smoking, diet and obesity have been shown to have disparate effects on women which may related to interactions between estrogen exposure, body fat distribution, and the biologic underpinnings of their tumors. There is data showing the uptake, choice, and efficacy of different CRC screening methods in women is dissimilar to that in men. The mortality benefit from FOBT, sigmoidoscopy, and protection from interval CRC by colonoscopy appears to be lower in women than men. A greater understanding of these gender idiosyncrasies will facilitate an personalized approach to CRC prevention and should ultimately lead to a reduced burden of disease.
机译：结直肠癌（CRC）是美国女性和男性的主要癌症之一，也是导致癌症死亡的原因。男性和女性的终生CRC累积风险相似，但是，他们之间在风险因素，肿瘤生物学和癌症预防服务的有效性方面存在显着差异。这篇评论摘录了证据，证明观察到的与CRC风险因素，筛查和预防有关的性别之间的独特差异。全世界一致的证据表明，女性达到的腺瘤和CRC的水平与男性相同，但其生命比男性晚了近十年。女性患有高甲基化，微卫星不稳定性且位于近端结肠中的肿瘤比例更高，这表明与男性相比，锯齿状通路对她们的影响更大。已显示其他CRC危险因素，例如吸烟，饮食和肥胖对妇女有不同的影响，这可能与雌激素暴露，体内脂肪分布及其肿瘤的生物学基础之间的相互作用有关。有数据显示，不同的CRC筛查方法在女性中的摄取，选择和功效与男性不同。女性从FOBT，乙状结肠镜检查以及结肠镜检查对间隔性CRC的保护中获得的死亡率似乎低于男性。对这些性别特质的更多了解将有助于采取个性化的CRC预防方法，并最终减少疾病负担。

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