Colorectal cancer screening: Clinical guidelines and rationale

被引:1557
作者
Winawer, SJ
Fletcher, RH
Miller, L
Godlee, F
Stolar, MH
Mulrow, CD
Woolf, SH
Glick, SN
Ganiats, TG
Bond, JH
Rosen, L
Zapka, JG
Olsen, SJ
Giardiello, FM
Sisk, JE
vanAntwerp, R
BrownDavis, C
Marciniak, DA
Mayer, RJ
机构
[1] CORNELL UNIV MED COLL, NEW YORK, NY USA
[2] HARVARD UNIV, SCH MED, BOSTON, MA 02115 USA
[3] HARVARD UNIV, SCH PUBL HLTH, BOSTON, MA 02115 USA
[4] VET ADM MED CTR, GASTROENTEROL SECT, MINNEAPOLIS, MN USA
[5] UNIV CALIF SAN DIEGO, LA JOLLA, CA 92093 USA
[6] JOHNS HOPKINS UNIV, HEREDITARY COLON CANC & POLYPOSIS CLIN, BALTIMORE, MD USA
[7] MED COLL PENN & HAHNEMANN UNIV, DIV GASTROINTESTINAL RADIOL, PHILADELPHIA, PA 19102 USA
[8] BRITISH MED JOURNAL, LONDON, ENGLAND
[9] ONCOL WISCONSIN SC, MILWAUKEE, WI USA
[10] DANA FARBER CANC INST, DEPT MED, BOSTON, MA 02115 USA
[11] MILLER ECON CONSULTING, ALEXANDRIA, VA USA
[12] UNIV TEXAS, HLTH SCI CTR, SAN ANTONIO, TX 78285 USA
[13] JOHNS HOPKINS UNIV, SCH NURSING, BALTIMORE, MD USA
[14] PENN STATE UNIV, COLL MED, MILTON S HERSHEY MED CTR, ALLENTOWN, PA USA
[15] LEHIGH VALLEY HOSP CTR, ALLENTOWN, PA 18102 USA
[16] COLUMBIA UNIV, SCH PUBL HLTH, NEW YORK, NY USA
[17] AMER GASTROENTEROL ASSOC, BETHESDA, MD USA
[18] LASER CTR MARYLAND, SEVERNA PK, MD USA
[19] VIRGINIA COMMONWEALTH UNIV, MED COLL VIRGINIA, RICHMOND, VA 23298 USA
[20] UNIV MASSACHUSETTS, SCH MED, WORCESTER, MA 01605 USA
关键词
D O I
10.1053/gast.1997.v112.agast970594
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Evidence exists that reductions in colorectal cancer (CRC) mortality can be achieved through detection and treatment of early-stage CRCs and the identification and removal of adenomatous polyps, the precursor to these cancers. An expert, multidisciplinary panel was convened to review this evidence and to produce recommendations to guide clinicians and the public in making decisions regarding CRC screening and surveillance. As part of its review, the panel also commissioned a simulation model that estimates and compares the clinical consequences (benefits and major complications) of each screening approach. This guideline report presents the panel's recommendations with respect to screening and surveillance in people at average risk for CRC and those at increased risk because of a family history of CRC or genetic syndromes or a personal history of adenomatous polyps, inflammatory bowel disease, or curative-intent resection of CRC. The cost- effectiveness of potential screening strategies was taken into account when preparing the recommendations. A summary of the evidence on each screening test's performance, effectiveness, frequency, complications, 'and patient acceptance is included. Also provided are suggestions for ways to increase compliance with the recommendations, questions for which additional research is needed, and the results of the simulation model on screening consequences.
引用
收藏
页码:594 / 642
页数:49
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