Early Detection for Colorectal Cancer: ASCO Resource-Stratified Guideline

作者：Gilberto Lopes, Mariana C. Stern, Sarah Temin, Ala I. Sharara, Andrés Cervantes, Ainhoa Costas‐Chavarri, R. Engineer, Chisato Hamashima, Gwo Fuang Ho, Fidel David Huitzil, Mona Malekzadeh, Govind Nandakumar, Manish A. Shah, Catherine Teh, Sara E. Vázquez Manjarrez, Azmina Verjee, Rhonda K. Yantiss, Marcia Cruz Correa · 发表于：Journal of Global Oncology · 年份：2019 · DOI：10.1200/jgo.18.00213 · 被引用次数：90 · 研究领域：Colorectal Cancer Screening and Detection、Colorectal Cancer Surgical Treatments、Global Cancer Incidence and Screening

PURPOSE: To provide resource-stratified, evidence-based recommendations on the early detection of colorectal cancer in four tiers to clinicians, patients, and caregivers. METHODS: American Society of Clinical Oncology convened a multidisciplinary, multinational panel of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (Consensus Ratings Group) for two round(s) of formal ratings. RESULTS: Existing sets of guidelines from eight guideline developers were identified and reviewed; adapted recommendations form the evidence base. These guidelines, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of 75% or more. CONCLUSION: In nonmaximal settings, for people who are asymptomatic, are ages 50 to 75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the following screening options are recommended: guaiac fecal occult blood test and fecal immunochemical testing (basic), flexible sigmoidoscopy (add option in limited), and colonoscopy (add option in enhanced). Optimal reflex testing strategy for persons with positive screens is as follows: endoscopy;...