Monitoring of patients with colorectal cancer (a) General monitoring of risk groups
1. Fecal occult blood test every year 1, such as fecal occult blood positive, then further for colonoscopy or X-Double-made gas Dayton
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2. Sigmoidoscopy or lead enema every 5 years, 1 can of musical form 5_10 sigmoidoscopy or double contrast X-1 Lock enema. 1 every 10 years for colonoscopy.
Monitoring of patients with colorectal cancer (b) monitoring high-risk groups
Refers to the element of symptoms, the high-risk population screening of these populations, endoscopic investigation showed sigmoid colon cancer should be more active, starting as early as possible, to perform more frequent, often use large intestine mirror monitor checks.
(1) hereditary nonpolyposis colorectal cancer because of its pre-malignant disease of the relative performance of non-characteristic, and the diagnosis of most dependent on family history. Most polyps and cancer in which parts of sigmoidoscopy can not reach. Therefore, only select the entire colon checked regularly. Recommended to begin colonoscopy around the age of 25, or more than the earliest family age of onset of colorectal cancer 5 years earlier if the results were negative to be reviewed every 2 years 1. If the examination revealed polyps 1 annually for cancer is found, should be selected subtotal colon resection, and the remaining intestine to 1 year 1 times sigmoidoscopy.
(2) familial adenomatous polyposis patients with first-degree relatives the risk of contracting this disease is 50%. Mostly because of adenomas originating in the age of 16 years old 10_12 line to be 1 year colonoscopy.
(3) in patients with inflammatory bowel disease ulcerative colitis are at high risk of cancer 10 years before the disease risk is less, but then every 10 years and 9% of cancer patients. It is suggested that the prevalence of screening colonoscopy after the 8_10 conducted, if there is severe dysplasia, you need an immediate review. Crohn's patients with gastrointestinal cancer of the danger he walks to increase, if involving the entire colon, and ulcerative colitis are the same patients.
(4) positive family history of colorectal cancer first degree relatives of a family history of colorectal cancer than those without family history risk increased by 75% _80% of first-degree relatives of cancer patients for colonoscopy, adenomatous polyps found there the probability of 2 times the control group. So to have a family history of colorectal cancer are required to conduct annual stool occult blood test 1, each year 1 3_5 sigmoidoscopy. If you have more than one disease or a family degree relatives occurred in 55 colorectal cancer before the age of the patients, a more rigorous follow-up; such as colonoscopy found no tumor, then an annual fecal occult blood test 1, each conducted sigmoidoscopy 3_5 .
(5) patients with a history of adenomatous polyps, such as large adenomas (> 1cm), villous adenoma, multiple adenomas, or adenomas with poor differentiation, need to undergo colonoscopy follow-up review. Lesions after treatment of such patients the time interval can be reviewed more than 1 year. Including concurrent small adenomas do not need to be followed up after endoscopic removal of large adenomas after treatment review may be reviewed in 3 years.
Monitoring of patients with colorectal cancer (6) history of colorectal cancer surgery is currently recommended in most months and 1 year 3_6 check whether anastomotic recurrence. New lesions in the adenoma – carcinoma sequence evolved, generally considered to be 10 years or more, so review of colonoscopy after colorectal cancer, such as found in adenomas, 3 years recommended for 1 times, check the negative, may be deferred to 5 years.