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Do Recent Epidemiologic Observations Impact Who and How We Should Screen for CRC?

机译：最近的流行病学观察会影响到谁以及如何筛查CRC？

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Colorectal cancer (CRC) screening is recommended to begin at age 50 for those patients with no significant family history of CRC. However, even within this group of average-risk patients, there is data to suggest that there may be variation in CRC risk. These observations suggest that perhaps CRC screening should be tailored to target those patients at higher risk for earlier or more invasive screening as compared to those individuals at lower risk. The strategy of how to identify those higher-risk patients may not be straightforward. One method might be to use single risk factors such as smoking or elevated BMI as has been suggested in the recent American College of Gastroenterology CRC screening guidelines. Another paradigm involves the use of models which incorporate several risk factors to stratify patients by risk. This article will highlight recent large studies that examine recognized CRC risk factors as well as review recently developed CRC risk models. There will also be a discussion of the application of these factors and models in an effort to make CRC screening more efficient.
机译：对于没有明显家族史的患者，建议从50岁开始进行大肠癌筛查。但是，即使在这组平均风险患者中，也有数据表明CRC风险可能存在差异。这些观察结果表明，与那些较低风险的个体相比，也许应该对CRC筛查进行调整，以针对较高风险的那些患者进行早期或更侵入性筛查。如何识别那些高危患者的策略可能并不简单。一种方法可能是使用单因素风险因素，例如吸烟或BMI升高，这在最近的美国胃肠病学院CRC筛查指南中已经提出。另一个范式涉及使用模型，该模型包含多个风险因素，以按风险对患者进行分层。本文将重点介绍最近的大型研究，这些研究检查公认的CRC风险因素，并回顾最近开发的CRC风险模型。还将讨论这些因素和模型的应用，以提高CRC筛查的效率。

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