2021年5月,美国预防服务工作组开始建议在45岁开始结直肠癌筛查(与50)年。
我们估计了结直肠癌筛查的患病率(通过结肠镜检查,乙状结肠镜检查,CT结肠造影,或基于粪便的测试)使用2000年,2003年,2005年,2008年,2010年,2013年,2015年和2018年的国家健康访谈调查数据对50至75岁的成年人进行。对于每个调查年,我们按年龄估计患病率,种族/民族,教育程度,家庭收入,和健康保险。我们还比较了5岁年龄组(50-54、55-59、60-64、65-69和70-75岁)从2000年到2018年筛查患病率的增加。
总的来说,结直肠癌筛查的患病率从2000年的36.7%上升至2018年的66.1%.2018年筛查患病率最低,年龄为50至54岁(47.6%),西班牙裔(56.5%),亚洲人(57.1%),和低于高中学历的参与者(53.6%),低收入家庭(56.6%),或没有保险(39.7%)。随着时间的推移,患病率的增加因5岁年龄组而异。例如,50~54岁人群的患病率从2000年的28.2%上升至2018年的47.6%(+19.4%;95%CI,13.1~25.6),但70~75岁人群的患病率从46.4%上升至78.0%(+31.6%;95%CI,25.4%~37.7%).这种模式在种族/民族之间是一致的,教育程度,家庭收入,和健康保险。
在50至54岁的成年人中,结直肠癌筛查的患病率仍然很低。
随着新准则的实施,必须注意确保所有人群平等地实现筛查福利,特别是45至49岁的新符合条件的成年人。参见Brawley的相关评论,第1671页。
In May 2021, the U.S. Preventive Services Task Force began recommending initiating colorectal cancer screening at age 45 (vs. 50) years.
We estimated prevalence of colorectal cancer screening (by colonoscopy, sigmoidoscopy, CT colonography, or stool-based tests) in adults ages 50 to 75 years using data from the National Health Interview Survey in 2000, 2003, 2005, 2008, 2010, 2013, 2015, and 2018. For each survey year, we estimated prevalence by age, race/ethnicity, educational attainment, family income, and health insurance. We also compared increases in prevalence of screening from 2000 to 2018 in 5-year age groups (50-54, 55-59, 60-64, 65-69, and 70-75 years).
Overall, prevalence of colorectal cancer screening increased from 36.7% in 2000 to 66.1% in 2018. Screening prevalence in 2018 was lowest for age 50 to 54 years (47.6%), Hispanics (56.5%), Asians (57.1%), and participants with less than a high school degree (53.6%), from low-income families (56.6%), or without insurance (39.7%). Increases in prevalence over time differed by five-year age group. For example, prevalence increased from 28.2% in 2000 to 47.6% in 2018 (+19.4%; 95% CI, 13.1-25.6) for age 50 to 54 years but from 46.4% to 78.0% (+31.6%; 95% CI, 25.4%-37.7%) for age 70 to 75 years. This pattern was consistent across race/ethnicity, educational attainment, family income, and health insurance.
Prevalence of colorectal cancer screening remains low in adults ages 50 to 54 years.
As new
guidelines are implemented, care must be taken to ensure screening benefits are realized equally by all population groups, particularly newly eligible adults ages 45 to 49 years. See related commentary by Brawley, p. 1671.