CT虚拟结肠镜.ppt

* * While there has been a downward trend during recent years in the use of FOBT, the prevalence of flexible sigmoidoscopy (FSIG) or colonoscopy increased from 1999 to 2004. Adults with less than a high school education were less likely to report FSIG or colonoscopy than all adults. Even more striking is that the prevalence for adults with no health insurance is approximately 26 percentage points lower than the prevalence for all adults. Continuing efforts are needed to address health system barriers to colon cancer screening, to encourage health care practitioners to promote screening to their patients, and to raise awareness among eligible adults about the importance of getting screened for CRC. * In 2004, approximately 19% of US adults 50 and older had a fecal occult blood test (FOBT) in the previous year. Adults with less than a high school education are less likely to report a recent FOBT. The prevalence for adults with no health insurance is approximately 10 percentage points lower than the prevalence for all adults. * The above are reasons for not being screened for colorectal cancer as stated by patients in a number of different studies. The reasons are not arranged by frequency of this response, nor are all of these reasons stated in all studies. * Expert panel reviewed and deliberated on available evidence during two face-to-face meetings and a series of conference calls Literature published between January 2002 and January 2008, as well as unpublished abstracts and manuscripts, were reviewed by panel Priority placed on prospective studies of asymptomatic adults, with all subjects undergoing colonoscopy Relatively few studies meet this “gold standard” criteria Limitations of available evidence: Prospective studies are rare Sample sizes tend to be small Study participants often include higher risk and/or symptomatic patients Colonoscopy often not performed, or performed in only a subset of the study population Quality of the supporting evidence for