- 期刊
大腸直腸癌篩檢於老年人之應用
Colorectal Cancer Screening in Older Adults
摘要
大腸直腸癌的高盛行率和高發生率對台灣老年族群的人口健康影響甚鉅。目前有充份的實證顯示，針對50歲以上的族群進行大腸直腸癌篩檢，可有效降低大腸直腸癌的發生率及癌症相關死亡率，也因此我國國民健康署針對50歲至75歲的民眾，免費提供每2年1次的大腸直腸癌癌篩。然而，愈來愈多證據顯示，癌症的篩檢效益隨著年齡的增加和共病的增加而下降。此外，老年族群進行大腸直腸癌篩檢可能有更高的篩檢風險與併發症。再者，老年族群即使早期診斷，其治療預後仍較差。最後，老年人對於癌症篩檢常缺乏全面性的了解。本篇以老年族群為探討對象，回顧分析目前大腸直腸癌的篩檢工具和臨床指引，探討老年人接受大腸直腸癌篩檢之效益和風險。建議臨床醫師在推廣大腸直腸癌篩檢的同時，應全面性地評估長者的健康情形、平均餘命及篩檢利弊，個別化地協助長者選擇適當的篩檢工具，以及討論何時應該停止癌症篩檢。
並列摘要
Colorectal cancer (CRC) is the third most common cancer in the world. CRC is common in the elderly, and the prevalence and incidence increase with aging. Studies supported CRC screening may prevent CRC and CRC-related death. Among current guidelines, there is substantial consensus on beginning colorectal cancer screening at the age of 50; however, there are no clear screening recommendations for older adults. More and more evidences suggested the benefit of screening may be reduced with increasing age and disease burden. We reviewed updated guidelines and addressed a number of the challenges and controversies surrounding CRC screening in older adults. The aim is to provide clinicians more consideration as promoting colorectal cancer screening in the elderly.
延伸閱讀
- 邱瀚模（2010）。大腸直腸癌篩檢策略之評估〔博士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2010.00006
- Lo, S. L., Lee, H. C., Shen, M. H., & Chang, S. C. (2014). 老年人大腸直腸癌病人回顧性縱向分析. 中華民國大腸直腸外科醫學會雜誌, 25(4), 115-121. https://doi.org/10.6312/SCRSTW.2014.25(4).10219
- Cheng, C. Y., Wang, H. M., & Chen, J. B. (2005). 腹腔鏡大腸直腸手術於老年人的應用. 中華民國大腸直腸外科醫學會雜誌, 16(3), 67-72. https://doi.org/10.6312/SCRSTW.2005.16(3).09409
- Hsu, T. W., Wei, C. K., Chang, C. M., Lin, S. P., Lin, C. H., Lee, C. H., Wu, C. C., & Yin, W. Y. (2018). 老年人因大腸直腸急症接受哈特曼手術後手術死亡的預測因子. 中華民國大腸直腸外科醫學會雜誌, 29(1), 56-63. https://doi.org/10.6312/SCRSTW.2018.29(1).10625
- 梁約翰（2006）。Regular Screening and Prompt Treatment Reduce Risk of Colorectal Cancer。中華民國航空醫學暨科學期刊，20(1)，33-36。https://doi.org/10.7011/JAMSRC.200606.0033