文章摘要
苏宇,湛浩然,孙鑫,陈茹,孙丽,郝金娟,张效鹏,田雨,陈瑞.全球针对家族史高危人群的结直肠癌筛查指南推荐意见的系统综述[J].中华流行病学杂志,2022,43(9):1469-1478
全球针对家族史高危人群的结直肠癌筛查指南推荐意见的系统综述
Global guidelines of colorectal cancer screening in high-risk population with family history of colorectal cancer: a systematic review
收稿日期:2022-04-22  出版日期:2022-09-09
DOI:10.3760/cma.j.cn112338-20220422-00331
中文关键词: 结直肠癌  筛查  指南  系统综述  家族史  全球
英文关键词: Colorectal cancer  Screening  Guidelines  Systematic review  Family history  Worldwide
基金项目:首都医科大学科研培育基金(校社科-常规项目)(PYS2101)
作者单位E-mail
苏宇 首都医科大学公共卫生学院, 北京 100069  
湛浩然 首都医科大学公共卫生学院, 北京 100069  
孙鑫 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院, 北京 100021  
陈茹 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院, 北京 100021  
孙丽 人民卫生出版社有限公司, 北京 100021  
郝金娟 北京医院/国家老年医学中心/中国医学科学院老年医学研究院, 北京 100730  
张效鹏 北京大学肿瘤医院暨北京市肿瘤防治研究所/胃肠肿瘤中心一病区/恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100142 md_boing@163.com 
田雨 首都医科大学公共卫生学院, 北京 100069 yutian@ccmu.edu.cn 
陈瑞 首都医科大学公共卫生学院, 北京 100069  
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中文摘要:
      目的 对全球现有结直肠癌家族史高危人群筛查指南的更新进展及推荐意见进行系统总结和评价。方法 以“结直肠癌”“筛查”“指南”“共识”“推荐”“家族史”以及“colorectal cancer”“screening”“guideline”“recommendation”“family history”为关键词,并补充其自由词,系统检索中国知网、万方数据知识服务平台、PubMed、Embase、Cochrane Library、Web of Science,并且同时检索官网刊登的结直肠癌筛查指南/共识作为补充,语种限定为中文和英文。截至2022年5月24日,共20篇有效文献。对纳入文献的基本信息、针对家族史人群的推荐意见等进行摘录整理及汇总描述。结果 在20篇文献中,大多数国家/地区/机构根据结直肠癌家族史人群的亲属关系等级,对筛查起止年龄、筛查方式及筛查周期提出建议。多数指南针对有1例60岁前患结直肠癌一级亲属的人群,推荐筛查起始年龄为40岁或比患病亲属诊断年龄提前10年,推荐的筛查方式多为结肠镜。结论 目前全球多数结直肠癌家族史高危人群筛查指南主要针对一级亲属家族史、以结肠镜作为主要筛查方式。本文将为我国针对结直肠癌家族史高危人群筛查策略的更新提供参考依据,进而完善结直肠癌筛查与早诊早治实践。
英文摘要:
      Objective To systematically summarize and evaluate the development of update and detailed recommendations of the existing global screening guidelines in high-risk population with a family history of colorectal cancer.Methods The words"colorectal cancer","screening","guideline","consensus","recommendations"and"family history"in Chinese and English were used as MESH terms for literature retrieval,as well as entry terms.The retrieval was performed based on China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,PubMed,Embase,Cochrane Library and Web of Science,as well as official websites.The languages of literatures were limited in Chinese and English.As of May 24,2022,a total of 20 valid literatures had been retrieved.The basic information of the literatures and the recommendations of colorectal cancer screening for people with family history were collected and analyzed.Results The analysis on the 20 literatures indicated that most countries/regions/institutions recommended age range of screening,screening modalities and intervals for people with family history of colorectal cancer.For the individuals who have one first-degree relative diagnosed with colorectal cancer before 60 years of age,most guidelines recommended the screening to be started at 40 years or 10 years earlier than the age when the youngest first-degree relative was diagnosed.The most commonly recommended screening modality was colonoscopy.Conclusions Most current screening guidelines for high-risk people with family history of colorectal cancer recommend colonoscopy as the main modality.This review will provide reference for the update of screening strategies in high-risk people with family history of colorectal cancer in China,and further improve the practices of screening,early diagnosis and treatment of colorectal cancer.
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