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🌱 來自: colorectal cancer

Screening of colorectal cancer

(JAMA 2021;325:1965)

• Average-risk Pts: start at ↣ age 45, repeat q1-10y based on screening modality
• ↑ risk Pts: ⊕ FHx: screen age 40 or 10 y before index dx, then → q5y. IBD: colo 8-10 y after dx, then → q1-2y. Suspect familial syndrome: genetic counsel, screen age 20-25, yearly.
• colonoscopy of Screening of colorectal cancer
• Sigmoidoscopy: benefit w/ 1-time flex-sig (Lancet 2017;389:1299); less Se than colo or CTC
• CT colonography (CTC): ~90% Se for lesions ≥1 cm but less if smaller (NEJM 2008;359:1207). If high-risk, Se only 85% for neoplasia ≥6 mm (JAMA 2009;301:2453).
• Combo DNA + Hb immunoassay w/ ~90% Se & Sp (NEJM 2014;370:1287)
• Occult blood (FOBT): use 3-card home testing (Se 24%) yearly