In recent years, the incidence rate of colorectal cancer in China has been rising year by year and has ranked the 3rd-5th among malignant tumors. Colorectal adenoma is the most important precancerous disease of colorectal cancer. Domestic and international experience has confirmed that removal of adenomas can effectively prevent the occurrence of colorectal cancer, and colonoscopy is the most effective method to detect colorectal adenomas and carcinomas. Due to the huge population base in China, colonoscopy to screen colorectal cancer in the whole population is not only costly, but also the number of colonoscopies required is beyond the affordability of the current medical system, so selective screening is needed, which can significantly improve the screening efficiency and reduce the waste of resources.
I. Initial screening to identify high-risk groups, followed by colonoscopy for high-risk groups: the age of the target group is determined to be 50-74 years old. High-risk includes any of the following.
1. Positive fecal occult blood test;
2. First-degree relatives (father, mother, siblings, children) with a history of colorectal cancer;
3.History of colorectal adenoma;
4.History of cancer;
5.Meets any 2 of the following 6 items.
a. Chronic diarrhea;
b. Chronic constipation;
c. Mucus and blood stool;
d. History of chronic appendicitis or appendectomy;
e, chronic cholecystitis or history of cholecystectomy;
f, long-term mental depression (including: divorce, death of spouse, death of first-degree relative, etc.).
Second, opportunistic screening: it is the screening of outpatients and healthy physical examiners. Including.
1, general individuals: routine fecal occult blood test, positive individuals are recommended to perform a colonoscopy fine examination.
2, high-risk individuals: direct full colonoscopy is recommended, regardless of the fecal occult blood test results.
Individuals at high risk are those who have one of the following six items.
a. Those with gastrointestinal symptoms, such as blood in stool, mucus stool and abdominal pain; unexplained anemia or weight loss;
b. Individuals with a history of colorectal cancer;
c. Individuals with pre-cancerous colorectal diseases such as colorectal adenoma, ulcerative colitis, Crohn’s disease, schistosomiasis, etc;
d. Immediate family members with a history of colorectal cancer
f.History of colorectal polyps in the immediate family;
e. History of pelvic radiotherapy.