指南与规范
ENGLISH ABSTRACT
中国结直肠癌筛查与早诊早治指南(2020,北京)
国家癌症中心中国结直肠癌筛查与早诊早治指南制定专家组
作者及单位信息
·
DOI: 10.3760/cma.j.cn112152-20210105-00010
China guideline for the screening, early detection and early treatment of colorectal cancer (2020, Beijing)
National Cancer Center, China, Expert Group of the Development of China Guideline for the Screening, Early Detection and Early Treatment of Colorectal Cancer
He Jie
Authors Info & Affiliations
National Cancer Center, China, Expert Group of the Development of China Guideline for the Screening, Early Detection and Early Treatment of Colorectal Cancer
He Jie
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
·
DOI: 10.3760/cma.j.cn112152-20210105-00010
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摘要

结直肠癌是威胁我国居民生命健康的主要癌症之一,造成了严重的社会负担。结直肠癌筛查与早诊早治是降低人群结直肠癌死亡率的有效措施。参考国际指南制定标准制定符合中国国情的结直肠癌筛查与早诊早治指南势在必行。指南由国家癌症中心发起,联合多学科专家,采用世界卫生组织推荐的指南制定原则和方法,针对结直肠癌筛查与早诊早治相关专业人员所关注的13个临床问题,给出了详细的循证推荐,旨在规范结直肠癌筛查与早诊早治实践,提升中国结直肠癌防控效果。

结直肠肿瘤;筛查;早诊早治;指南
ABSTRACT

Colorectal cancer (CRC) is a major malignancy threatening the health of people in China, which also leads to heavy social burden. A large number of researches and practices have demonstrated that screening and early detection are effective in reducing the mortality of CRC. It is therefore imperative to design guidelines for the screening, early detection and early treatment of CRC that are in line with national conditions of China based on international guideline development standard. In 2020, under the leadership of the National Cancer Center of China, a multidisciplinary guideline development group was established. The development of the guideline followed the principles and methods recommended by the World Health Organization. The guideline provides detailed recommendations for thirteen key clinical questions to which the professionals who are involved in screening, early detection and early treatment of colorectal cancer paid close attention. The guideline is intended to serve as a tool for professionals providing best decision-making on screening, early detection and early treatment of CRC and to enhance the effectiveness of CRC prevention and control in China.

Colorectal neoplasms;Screening;Early diagnosis and early treatment;Guideline
He Jie, Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China, Email: nc.defcaab.smaciceijeh
引用本文

国家癌症中心中国结直肠癌筛查与早诊早治指南制定专家组. 中国结直肠癌筛查与早诊早治指南(2020,北京)[J]. 中华肿瘤杂志,2021,43(01):16-38.

DOI:10.3760/cma.j.cn112152-20210105-00010

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一、引言
结直肠癌是威胁我国居民生命健康的主要癌症之一,造成了严重的社会负担。根据国家癌症中心公布的最新数据,2015年中国结直肠癌新发病例38.76万例,占全部恶性肿瘤发病的9.87%;由结直肠癌导致的死亡病例18.71万例,占全部恶性肿瘤死亡的8.01% [ 1 ]。如何有效地降低我国结直肠癌疾病负担是亟待解决的重大公共卫生问题。
结直肠癌的发生发展大多遵循"腺瘤—癌"序列,从癌前病变进展到癌一般需要5~10年的时间,为疾病的早期诊断和临床干预提供了重要时间窗口 [ 2 ]。此外,结直肠癌的预后与诊断分期紧密相关。Ⅰ期结直肠癌的5年相对生存率为90%,而发生远处转移的Ⅳ期结直肠癌5年相对生存率仅为14% [ 3 ]。大量的研究和实践已经表明结直肠癌筛查和早诊早治可以有效降低结直肠癌的死亡率 [ 4 , 5 ]。我国的结直肠癌筛查起步于20世纪70年代结直肠癌高发现场(如浙江省嘉善县和海宁市)的防治工作。近10年来,随着我国结直肠癌负担不断增加,国家和地方开始逐步推进公共卫生服务项目,在更多的地区逐步开展了人群结直肠癌筛查项目,取得了较好的社会效益。
随着人群结直肠癌筛查项目的广泛开展,规范结直肠癌筛查与早诊早治技术和实施方案对保证结直肠癌防控效果至关重要。若干学术团体已经发布了一系列专家共识意见 [ 6 , 7 ],但目前我国仍缺乏基于循证医学证据的结直肠癌筛查与早诊早治指南。因此,国家癌症中心成立了中国结直肠癌筛查与早诊早治指南制定专家组,联合肿瘤学、消化内科学、内镜学、外科学、病理学、临床检验学、流行病学、循证医学、卫生经济学和卫生管理学等多学科专家,基于世界卫生组织推荐的指南制定原则和方法,制定了本指南,以期为我国结直肠癌筛查与早诊早治的规范开展提供参考,提升我国结直肠癌防控效果。
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备注信息
A
赫捷,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胸外科,Email: nc.defcaab.smaciceijeh
B
感谢以下专家在本指南制定过程中提出的宝贵建议(按姓氏汉语拼音排序):曹雪源、陈光勇、陈泓磊、陈睿妍、陈寅波、方军、冯海洋、付志璇、高琴琰、龚继勇、郭嫦媛、何玉琦、贺东黎、胡旭化、姜晶、姜文珍、雷福明、李博、李国东、李纪鹏、李琳、李瑞君、李士杰、李晓锋、刘勇、刘震雄、宁晓燕、秦朝、任重、宋杰、苏丹、孙锁柱、王慜杰、王秋实、魏九峰、吴嘉钏、吴培德、许丽霞、闫炎、杨帆、应荣彪、游燕、于滨、于双妮、张宁、张胜威、张绪慧、赵贵君、赵天成、曾育杰、郑朝旭、钟芸诗、周宝森、朱靖、朱玉萍
C
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