Screening for high-risk groups of colorectal cancer generally begins with age. Professor Hu introduced that the median age of onset of colorectal cancer in China is about 45 years old, and the incubation period of colorectal cancer is about 10 years. Therefore, the age of the high-risk population of colorectal cancer in China can be set at 35 years old, and it is suggested that the general population over 45 years old should undergo colonoscopy.
Patients with colorectal adenoma should be highly alert to intestinal cancer. A large number of studies show that colorectal cancer mucosa with adenoma is more likely to become cancerous than normal mucosa without adenoma 100 times, and 30%-50% patients with colorectal adenoma will develop into adenoma in the future after the first resection of adenoma, so patients with colorectal adenoma should still be closely followed up after treatment.
Multiple familial polyposis is a hereditary disease, and about 40% offspring can inherit it. Generally, multiple colorectal adenomas (mostly tubular adenomas and a few villous adenomas) began to appear at the age of 8- 10. Around the age of 20, the whole colorectal can be covered with hundreds of adenomas of different sizes. Without active treatment, cancer may occur around the age of 40.
About 2.5%- 1 1% of patients with colorectal cancer can develop primary colorectal cancer after radical operation. Therefore, patients with colorectal cancer should be followed up as a high-risk group after radical surgery.
Foreign scholars have reported that the incidence of rectal cancer after radiotherapy for cervical cancer is four times higher than that of the general population, so people who have received pelvic radiotherapy may be at high risk for rectal cancer.
The probability of colorectal cancer in patients with chronic ulcerative colitis is 5- 10 times that of normal people, which mainly harms those with persistent lesions, while the risk of cancer in patients with transient ulcerative colitis is close to normal people.
A large number of studies have found that the incidence of colorectal cancer in the families of patients with colorectal cancer is about 3 times higher than that in the control group. Statistical analysis shows that this is mainly related to the same diet structure. You know, healthy intestines especially "hate" barbecue and fried food, so cooking methods need to be improved. In addition, asbestos workers and those with a history of breast cancer should also pay attention to the possibility of colorectal cancer.
The above list belongs to the high-risk group of colorectal cancer. Professor Hu pointed out that early and regular screening is the most powerful weapon to deal with colorectal cancer. Colorectal polyps may take as long as 10 to 15 years to develop into colorectal cancer. Regular screening can not only prevent further canceration by finding and removing some types of colorectal polyps, but also help people find and diagnose colorectal cancer in time at the early stage when the tumor is small, has not spread and is easy to treat.
Commonly used screening methods for colorectal cancer include stool examination, colonoscopy and blood test. At present, colonoscopy and subsequent pathological examination are the gold standard for the diagnosis of colorectal cancer, and it is recommended to be the first choice. Carcinoembryonic antigen (CEA) is currently recognized as a blood marker of colorectal cancer, but its sensitivity and specificity are not high, so its monitoring significance for the therapeutic effect and recurrence of colorectal cancer is greater than early diagnosis and screening.
Early detection of colorectal cancer (stage ⅰ and ⅱ) has a high survival rate and cure rate. The general population has been screened for colorectal cancer since the age of 45, and colonoscopy is done every five years. Colon polyp patients have colonoscopy once a year. High-risk groups of colorectal cancer should start routine screening earlier (40 or even 30 years old). When colonoscopy finds early colorectal polyps and other precancerous lesions, it should be treated in time to reduce the risk of colorectal cancer.
(Pan Jiayi)