Review: colorectal cancer screening with the faecal occult blood test reduced colorectal cancer mortality.

摘要

Colorectal cancer is a global problem that accounts for about 655000 deaths each year worldwide.1 Precancerous polyps can remain in situ for years before cancer develops, and early detection with polyp removal effectively decreases colorectal cancer incidence. Early treatment of cotorectal cancer increases survival. Despite these benefits, screening rates remain low.2 The Cochrahe systematic review by Hewifson ef al updates a previous review and provides strong evidence that annual faecal occult blood screening with diagnostic evaluation reduces cancer mortality when compared with no screening. Strengths of the review are a rigorous methodology and discussion of the risks and benefits of screening. On a cautionary note, a high rate of false positives was found in most of the included studies. This would lead to negative psychosocial or physical sequalae for a substantial number of people who complete the screening test. Another limitation of the review is the inability to detect any decrease in all-cause mortality because of difficulty tn measuring the effect of comorbidities on patients with colorectal cancer.Population screening is recommended to decrease colorectal cancer incidence and mortality. Specific groups at increased risk of colorectal cancer are ageing people and those with a family history of the disease. Implications of this review are particularly relevant to nursing because nurses typically provide patient education. The authors recommend further research on the information needs of individuals before screening and on the type of information that should be provided. Recently, Wackerbarth ef a discussed 10 areas that influence decision making. Nurses should address these areas with people who are considering colorectal cancer screening.