RT Journal Article
SR Electronic
T1 Asia Pacific consensus recommendations for colorectal cancer screening
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 1166
OP 1176
DO 10.1136/gut.2007.146316
VO 57
IS 8
A1 J J Y Sung
A1 J Y W Lau
A1 G P Young
A1 Y Sano
A1 H M Chiu
A1 J S Byeon
A1 K G Yeoh
A1 K L Goh
A1 J Sollano
A1 R Rerknimitr
A1 T Matsuda
A1 K C Wu
A1 S Ng
A1 S Y Leung
A1 G Makharia
A1 V H Chong
A1 K Y Ho
A1 D Brooks
A1 D A Lieberman
A1 F K L Chan
YR 2008
UL http://gut.bmj.com/content/57/8/1166.abstract
AB Colorectal cancer (CRC) is rapidly increasing in Asia, but screening guidelines are lacking. Through reviewing the literature and regional data, and using the modified Delphi process, the Asia Pacific Working Group on Colorectal Cancer and international experts launch consensus recommendations aiming to improve the awareness of healthcare providers of the changing epidemiology and screening tests available. The incidence, anatomical distribution and mortality of CRC among Asian populations are not different compared with Western countries. There is a trend of proximal migration of colonic polyps. Flat or depressed lesions are not uncommon. Screening for CRC should be started at the age of 50 years. Male gender, smoking, obesity and family history are risk factors for colorectal neoplasia. Faecal occult blood test (FOBT, guaiac-based and immunochemical tests), flexible sigmoidoscopy and colonoscopy are recommended for CRC screening. Double-contrast barium enema and CT colonography are not preferred. In resource-limited countries, FOBT is the first choice for CRC screening. Polyps 5–9 mm in diameter should be removed endoscopically and, following a negative colonoscopy, a repeat examination should be performed in 10 years. Screening for CRC should be a national health priority in most Asian countries. Studies on barriers to CRC screening, education for the public and engagement of primary care physicians should be undertaken. There is no consensus on whether nurses should be trained to perform endoscopic procedures for screening of colorectal neoplasia.