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Diagnosis and emerging therapies in the treatment of colorectal cancer

机译：大肠癌的诊断和新兴疗法

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PURPOSE: Although it ranks among the top 3 leading causes of cancer and cancer-related deaths in the United States, only 30% of patients receive adequate screening for colorectal cancer (CRC). Educating and referring patients for screening and for treatment is critical, as CRC can be effectively treated and often cured if identified in its earliest stages. EPIDEMIOLOGY: In 2005 there will be an estimated 145 290 new cases (10% to 15% of all cancer cases) and 56 290 deaths (10% to 11% of all cancer deaths) from CRC. Apart from Australia and New Zealand, North America has the highest incidence of CRC worldwide. REVIEW SUMMARY: This article describes the diagnostic and staging processes for CRC based on patient history, physical examination, and key diagnostic tests. However, often the disease is not diagnosed in its earliest stages. A number of new treatments, including adjuvant chemotherapy and radiation therapy, have doubled the lifespan of patients with metastatic disease in the past 10 years. Genetically engineered and individually tailored treatments may hold the key to the future treatment of this and other forms of cancer. TYPE OF AVAILABLE EVIDENCE: Systematic reviews, randomized-controlled trials, cohort studies, unstructured reviews, nationally recognized treatment guidelines. GRADE OF AVAILABLE EVIDENCE: Fair to good. CONCLUSION: Future emphasis on screening, research into the complex genetic and environmentally linked etiologies for CRC, and development of new, more effective, less toxic chemotherapeutic regimens will continue to augment ever-advancing surgical techniques.
机译：目的：尽管它在美国癌症和癌症相关死亡的三大主要原因中排名第一，但只有30％的患者接受了大肠癌（CRC）的充分筛查。对患者进行筛查和治疗的教育和转介至关重要，因为如果能尽早发现CRC，则可以对其进行有效治疗，并且通常可以治愈。流行病学：2005年，CRC估计将导致145 290例新病例（占所有癌症病例的10％至15％）和56 290例死亡（占所有癌症死亡的10％至11％）。除澳大利亚和新西兰外，北美地区的CRC患病率最高。综述：本文根据患者病史，体格检查和关键诊断测试描述CRC的诊断和分期过程。但是，常常没有在早期诊断出该病。在过去的10年中，许多新疗法（包括辅助化疗和放射疗法）使转移性疾病患者的寿命延长了一倍。基因工程和个性化的治疗方法可能成为未来治疗这种和其他形式癌症的关键。可用证据类型：系统评价，随机对照试验，队列研究，非结构评价，国家认可的治疗指南。可用的证据等级：一般到良好。结论：未来将重点放在筛查，研究CRC的复杂遗传学和与环境有关的病因上，以及开发新的，更有效的，毒性较小的化学治疗方案，将继续增加不断发展的外科技术。

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