Recommendations for colorectal cancer screening and prevention

Publication Time:

2020-04-26 17:41

Source:

Recently, the Shanghai Anti-Cancer Association, in collaboration with Huashan Hospital affiliated with Fudan University, released the 2020 edition of "Recommendations on Screening and Prevention of Common Malignant Tumors in Residents" (hereinafter referred to as the "Recommendations"), advocating the "three early" concept of prevention, early detection, early diagnosis, and early treatment of malignant tumors.
Early diagnosis and treatment can greatly increase the chances of cure for most malignant tumors. The latest survival data from Huashan Hospital affiliated with Fudan University shows that early-stage colorectal cancer patients, after receiving standardized treatment, have a five-year survival rate exceeding 90%. Early detection and diagnosis can help patients recover and return to normal life. Below are the recommendations from the "Recommendations" regarding colorectal cancer screening and prevention.

High-Risk Individuals

1. Asymptomatic individuals aged 45 and above;
2. Individuals aged 40 and above with two weeks of anorectal symptoms [referring to any of the following symptoms lasting for two weeks or more: changes in bowel habits (constipation, diarrhea, etc.); changes in stool shape (thinning of stool); changes in stool properties (bleeding, mucus in stool); fixed abdominal pain];
3. Patients with long-term ulcerative colitis;
4. Post-colorectal cancer surgery individuals;
5. Post-colorectal adenoma treatment individuals;
6. Individuals with a family history of colorectal cancer in immediate family members;
7. Immediate family members of patients diagnosed with hereditary colorectal cancer (referring to familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC)), aged over 20.

Screening Recommendations

1. Screening for "General Population" meeting criteria 1-5:
(1) Colorectal cancer screening begins at age 45, for both men and women, with a fecal occult blood test (FOBT) once a year and a colonoscopy every 10 years, until age 75;
(2) For ages 76-85, healthy individuals with a life expectancy of 10 years or more may continue screening.
2. Screening for immediate family members with a family history of colorectal cancer:
(1) One first-degree relative with a confirmed high-grade adenoma or cancer (onset age less than 60), or two or more first-degree relatives with confirmed high-grade adenoma or cancer (any onset age): screening begins at age 40 (or 10 years before the youngest onset age in the family), with an annual FOBT and a colonoscopy every 5 years;
(2) High-risk individuals with one first-degree relative's family history (only one, and onset age above 60): screening begins at age 40, with an annual FOBT and a colonoscopy every ten years.
3. Screening for family members with hereditary colorectal cancer: For FAP and HNPCC family members, when the gene mutation of the index case in the family is clear, gene mutation testing is recommended.
(1) For those with a positive gene mutation test, a colonoscopy should be performed every 1-2 years after age 20;
(2) For those with a negative gene mutation test, screening should be conducted according to the general population guidelines.
4. Recommendations on Screening Methods:
(1) FOBT and questionnaires are the main screening methods, with sufficient evidence;
(2) Multi-target gene testing in blood may help improve the accuracy of screening but is more expensive;
(3) Those with the resources may combine stool and blood tests for screening.

Prevention Recommendations

1. Exercise can effectively reduce the incidence of tumors. Maintain regular physical exercise and avoid obesity;
2. Maintain a healthy diet, increase intake of high-fiber foods and fresh fruits, and avoid high-fat, high-protein diets;
3. Nonsteroidal anti-inflammatory analgesics may be effective in preventing colon cancer. Elderly individuals may consider taking low-dose aspirin, which may reduce the risk of cardiovascular disease and colon cancer. Consult your doctor before use;
4. Quit smoking to avoid its long-term toxicity and inflammatory stimulation to the digestive tract.

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