45 至 75 岁：接受筛查
如果您患结直肠癌的风险处于平均水平，请从 45 岁开始接受筛查。请参阅下文，了解适合您的筛查选项。如果您身体健康，预期寿命为 10 年或更长，请继续接受筛查直至 75 岁。
结直肠癌
它是什么？
Colorectal cancer is cancer that begins in the colon or rectum (everyone has a colon and rectum unless they have been surgically removed). This cancer can be prevented with a screening colonoscopy by removing polyps (grape-like growths on the wall of the large intestine, which includes both the colon and rectum) before they become cancerous. With routine screening using visual or stool-based tests, you can also detect the disease early when the cancer is small and hasn’t spread.
接受筛查
对于平均风险人群，应从 45 岁开始进行结直肠癌筛查（2021 年建议年龄从 50 岁降至 45 岁）。*
*来源：国家综合癌症网络
76-85 岁：咨询您的医生
如果您的年龄在 76-85 岁之间，请咨询您的医疗保健提供者是否继续进行筛查。85 岁以后，您不应再进行筛查。
风险增加与平均风险
Based on your personal risk, some screening options may not be recommended for you. You may also need to start regular screening at an earlier age and/or be screened more often.
如果你处于平均风险水平，这意味着你 不要 有：
- 有炎症性肠病（如溃疡性结肠炎或克罗恩病）的个人病史。
- 有结直肠癌或某些类型息肉（腺瘤性或“扁平”息肉）的个人病史。
- 有结肠直肠癌家族病史。
- 遗传性结直肠癌综合征（如家族性腺瘤性息肉病 [FAP] 或林奇综合征）。
Recommended screening options
There are many options for colorectal cancer screening for those of average risk. Talk to your doctor to choose which test is right for you.
| 测试 | 筛选间隔 |
|---|---|
| 结肠镜检查 | 每 10 年 |
| 虚拟结肠镜检查* | 每 5 年 |
| 柔性乙状结肠镜检查* | 每 5 年 |
| 高灵敏度愈创木脂粪便潜血试验 (HS gFOBT) * | 每年 |
| 粪便免疫化学检测 (FIT)* | 每年 |
| 多目标粪便 DNA 测试 (mt-sDNA)* | 每 3 年 |
| Blood test*+ | 每 3 年 |
*Any abnormal or positive results from screening methods other than a colonoscopy should be followed up with a timely colonoscopy.
+Blood tests for colorectal cancer screening are recommended for those who can’t or won’t use other screening methods.
筛查覆盖率
The Affordable Care Act mandates that private insurers and Medicare cover certain colorectal cancer screenings. Insurance companies can also choose to cover other types of screening that are not required by law. Check with your insurance provider to find out if which screenings are covered under your insurance plan.
了解您的风险
如果您符合以下情况，则罹患结直肠癌的风险会增加：
- 年龄在 50 岁以上。
- 是黑色的。
- 抽烟。
- 超重或肥胖。
- 患有 2 型糖尿病。
- 缺乏身体活动。
- 过量饮酒。
- 吃大量红肉（如牛肉、猪肉或羊肉）或加工肉类（如培根、香肠、热狗或冷盘）。
- 有结直肠癌或结直肠息肉（腺瘤）的个人病史或家族病史。
- Have a personal or family history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease).
- Have a personal or family history of a hereditary colorectal cancer syndrome, such as Lynch Syndrome or Familial Adenomatous Polyposis (FAP).
降低风险
您可以通过以下与生活方式相关的改变来降低患结直肠癌的风险：
每周锻炼至少 5 天，每次至少 30 分钟。
避免或限制饮酒。
为了降低患癌症的风险，最好完全戒酒。如果你选择喝酒，如果你出生时被指定为女性，那么每天饮酒量不得超过一杯；如果你出生时被指定为男性，那么每天饮酒量不得超过两杯。
Avoid all forms of tobacco.
少吃红肉，不吃加工肉类。
保持健康的体重。
多吃水果、蔬菜、豆类和粗粮。
根据指南和个人风险因素进行结直肠癌筛查。
体征和症状
如果您出现以下任何症状，请立即与您的医疗保健提供者联系：
- 直肠出血或粪便内或粪便上带血
- Unexplained iron-deficiency anemia
- 排便习惯改变持续数天以上
- 大便比平常更细
- General abdominal problems such as bloating, fullness or a feeling that you need to have a bowel movement that’s not relieved by having one
- Persistent abdominal cramps
- Unexplained vomiting, diarrhea or constipation
- 体重无明显原因减轻
- Unexplained fatigue
治疗方案
治疗取决于癌症的阶段、肿瘤细胞的类型和您的病情。
外科手术
结肠直肠癌最常见的治疗方法是手术。手术范围包括部分结肠切除术（切除部分结肠，也称为结肠切除术）和直肠结肠切除术（切除大肠和直肠）。
化疗
化疗使用药物杀死癌细胞。如果癌症已经扩散，可以在手术前或手术后使用化疗。
辐射
这种治疗使用高剂量的辐射来杀死癌细胞并缩小肿瘤。当癌症扩散时，可以在手术前或手术后使用辐射。
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