大肠癌人群筛查项目实施的国际进展

张芃; 蒋虹丽; 陈文; 顾凯; 龚杨明; 彭鹏

doi:10.19428/j.cnki.sjpm.2021.20241

大肠癌人群筛查项目实施的国际进展

A review of international progress in colorectal cancer screening programs

摘要

摘要:
目的介绍国内外大肠癌人群筛查项目经验，为我国开展和推广人群筛查提供参考。
方法基于中国知网和Web of Science数据库，输入关键词“大肠癌人群筛查项目”检索相关文献。
结果共检索到187篇中文文献和1 256篇英文文献，根据筛选条件和排除标准最终纳入18篇涉及17个人群筛查项目的文献。国内外大肠癌人群筛查项目是有组织的，筛查对象多为50~74岁无肛肠症状的自然人群；筛查方案多采用2年1次的免疫法粪便隐血试验进行初筛并建议初筛阳性者进行肠镜检查；项目实施减少了大肠癌和癌前病变的发病率，有助于大肠癌患者早诊断、早治疗；经济学评价显示，筛查项目具有良好的成本效果。
结论我国开展和推广大肠癌人群筛查项目应设计循证、可行的方案，重视项目的实施与管理，并同步做好项目监测和效果评价的实施方案。

Abstract:
ObjectiveTo summarize the international experience in colorectal cancer population screening programs， so as to provide reference for the development and promotion of similar programs in China.
MethodsWe used “colorectal cancer population screening program” as key words to search the database of CNKI and Web of Science in this study.
ResultsA total of 18 reports （including 17 programs） were selected from 187 Chinese and 1 256 English literatures. International colorectal cancer screening programs were organized to target asymptomatic 50-74 years old population for fecal immunochemical test every two years and recommend participants with positive result to take further colonoscopy. These programs reduced the incidence of colorectal cancer and adenoma， which were beneficial to early diagnosis and treatment in colorectal cancer patients. They also showed good cost-effectiveness.
ConclusionBased on the domestic and foreign experiences， we suggest to further improve colorectal cancer screening programs in China， including designing evidence-based and feasible strategies， attaching importance to the implementation and management of the programs， and simultaneously implementing project monitoring and effectiveness evaluation.

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