76歳以上の大腸癌検診は推奨しない

 
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 大腸癌検診についてUS Preventive Services Task Forceからのガイドラインが発表されています。
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Ann Intern Med. 2008 Nov 4;149(9):627-37. Epub 2008 Oct 6.
Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement.
U.S. Preventive Services Task Force.

http://www.ncbi.nlm.nih.gov/pubmed/18838716
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RECOMMENDATIONS:
The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary. (A recommendation). The USPSTF recommends against routine screening for colorectal cancer in adults 76 to 85 years of age. There may be considerations that support colorectal cancer screening in an individual patient. (C recommendation). The USPSTF recommends against screening for colorectal cancer in adults older than age 85 years. (D recommendation). The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer. (I statement).
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 76歳以上の定期検診は早期発見・治療による効果が少なく、害(内視鏡検査による深刻な合併症は400件に1件)もあり、勧められない、との勧告です。
 検診も費用対効果をよく検証しなければならないでしょう。
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