대장암 선별검사 권고안

The Guideline for Colorectal Cancer Screening

  • 박동일 (성균관대학교 의과대학 내과학교실)
  • Dong Il Park (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2016.05.27
  • 심사 : 2016.06.07
  • 발행 : 2016.06.30

초록

대장암 검진 권고안 개정위원회는 지금까지 발표된 대장암검진 관련 국내외 임상지침 및 최신 문헌 검색을 통한 체계적 근거 평가를 통해 근거중심의 대장암 검진 개정 권고안을 제시하였다. 또한 우선 권고되는 면역화학 분변잠혈검사법의 질관리 필요성과 대장내시경검사의 이득과 위해를 평가할 수 있는 정량화된 자료의 필요성, 국내 실정에 맞는 질관리 지표의 개발, 좀 더 다양한 위험인자를 고려하는 개별적인 접근법의 필요성 등을 지적하였다.

Colorectal cancer is the 2nd most common cancer in men, and the 3rd most common cancer in women in Korea. This incidence has been increasing steadily since the data analysis began in 1999. Guidelines from many countries including Korea recommend annual or biennial fecal occult blood test as a national colorectal cancer screening program, however, colonoscopy, stool DNA test, double contrast barium enema, and sigmoidoscopy are recommended in some countries. I will summarize the Korean National Screening Guideline for colorectal cancer revised by multi-society expert committee in Korea last year. They recommend annual or biennial fecal immunochemical test between 45 and 80 year-old asymptomatic average risk people. Selective use of colonoscopy is recommended, taking into consideration of individual preference and the risk of colorectal cancer. There is no evidence for the risks or benefits of double contrast barium enema or computed tomographic colonography for colorectal cancer screening.

키워드

참고문헌

  1. Jung KW, Won YJ, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 2015;47:127-141.
  2. Sohn DK, Kim MJ, Park Y, et al. The Korean guideline for colorectal cancer screening. J Korean Med Assoc 2015;58:420-432.
  3. Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L. Association of colonoscopy and death from colorectal cancer. Ann Intern Med 2009;150:1-8.
  4. Kahi CJ, Imperiale TF, Juliar BE, Rex DK. Effect of screening colonoscopy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol 2009;7:770-775.
  5. Manser CN, Bachmann LM, Brunner J, Hunold F, Bauerfeind P, Marbet UA. Colonoscopy screening markedly reduces the occurrence of colon carcinomas and carcinoma-related death: a closed cohort study. Gastrointest Endosc 2012;76:110-117.
  6. Nishihara R, Wu K, Lochhead P, et al. Long-term colorectal-cancer incidence and mortality after lower endoscopy. N Engl J Med 2013;369:1095-1105.
  7. Brenner H, Chang-Claude J, Seiler CM, Sturmer T, Hoffmeister M. Does a negative screening colonoscopy ever need to be repeated? Gut 2006;55:1145-1150.
  8. Cotterchio M, Manno M, Klar N, McLaughlin J, Gallinger S. Colorectal screening is associated with reduced colorectal cancer risk: a case-control study within the population-based Ontario Familial Colorectal Cancer Registry. Cancer Causes Control 2005;16:865-875.
  9. Singh H, Nugent Z, Mahmud SM, Demers AA, Bernstein CN. Predictors of colorectal cancer after negative colonoscopy: a population-based study. Am J Gastroenterol 2010;105:663-673.
  10. Citarda F, Tomaselli G, Capocaccia R, Barcherini S, Crespi M. Italian Multicentre Study Group. Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence. Gut 2001;48:812-815.
  11. Singh H, Turner D, Xue L, Targownik LE, Bernstein CN. Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies. JAMA 2006;295:2366-2373.
  12. Regula J, Rupinski M, Kraszewska E, et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med 2006;355:1863-1872.
  13. Pox CP, Altenhofen L, Brenner H, Theilmeier A, Von Stillfried D, Schmiegel W. Efficacy of a nationwide screening colonoscopy program for colorectal cancer. Gastroenterology 2012;142:1460-1467.
  14. Senore C, Ederle A, Fantin A, et al. Acceptability and side-effects of colonoscopy and sigmoidoscopy in a screening setting. J Med Screen 2011;18:128-134.
  15. Rutter CM, Johnson E, Miglioretti DL, Mandelson MT, Inadomi J, Buist DS. Adverse events after screening and followup colonoscopy. Cancer Causes Control 2012;23:289-296.
  16. Khalid-de Bakker CA, Jonkers DM, Hameeteman W, de Ridder RJ, Masclee AA, Stockbrugger RW. Cardiopulmonary events during primary colonoscopy screening in an average risk population. Neth J Med 2011;69:186-191.
  17. Levin TR, Zhao W, Conell C, et al. Complications of colonoscopy in an integrated health care delivery system. Ann Intern Med 2006;145:880-886.
  18. Lee YC, Wang HP, Chiu HM, et al. Factors determining post-colonoscopy abdominal pain: prospective study of screening colonoscopy in 1000 subjects. J Gastroenterol Hepatol 2006;21:1575-1580.
  19. Nelson DB, McQuaid KR, Bond JH, Lieberman DA, Weiss DG, Johnston TK. Procedural success and complications of large-scale screening colonoscopy. Gastrointest Endosc 2002;55:307-314.
  20. Brenner H, Chang-Claude J, Seiler CM, Hoffmeister M. Interval cancers after negative colonoscopy: population-based case-control study. Gut 2012;61:1576-1582.
  21. Farrar WD, Sawhney MS, Nelson DB, Lederle FA, Bond JH. Colorectal cancers found after a complete colonoscopy. Clin Gastroenterol Hepatol 2006;4:1259-1264.
  22. Bressler B, Paszat LF, Chen Z, Rothwell DM, Vinden C, Rabeneck L. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology 2007;132:96-102.
  23. Mandel JS, Bond JH, Church TR, et al. Minnesota Colon Cancer Control Study. Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med 1993;328:1365-1371.
  24. Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O. Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet 1996;348:1467-1471.
  25. Mandel JS, Church TR, Ederer F, Bond JH. Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood. J Natl Cancer Inst 1999;91:434-437.
  26. Jorgensen OD, Kronborg O, Fenger C. A randomised study of screening for colorectal cancer using faecal occult blood testing: results after 13 years and seven biennial screening rounds. Gut 2002;50:29-32.
  27. Scholefield JH, Moss S, Sufi F, Mangham CM, Hardcastle JD. Effect of faecal occult blood screening on mortality from colorectal cancer: results from a randomised controlled trial. Gut 2002;50:840-844.
  28. Kronborg O, Jorgensen OD, Fenger C, Rasmussen M. Randomized study of biennial screening with a faecal occult blood test: results after nine screening rounds. Scand J Gastroenterol 2004;39:846-851.
  29. Lindholm E, Brevinge H, Haglind E. Survival benefit in a randomized clinical trial of faecal occult blood screening for colorectal cancer. Br J Surg 2008;95:1029-1036.
  30. Whynes DK, Mangham CM, Balfour TW, Scholefield JH. Analysis of deaths occurring within the Nottingham trial of faecal occult blood screening for colorectal cancer. Gut 2010;59:1088-1093.
  31. Nakama H, Kamijo N, Abdul Fattah AS, Zhang B. Validity of immunological faecal occult blood screening for colorectal cancer: a follow up study. J Med Screen 1996;3:63-65.
  32. Liu HH, Huang TW, Chen HL, Wang TH, Lin JT. Clinicopathologic significance of immunohistochemical fecal occult blood test in subjects receiving bidirectional endoscopy. Hepatogastroenterology 2003;50:1390-1392.
  33. Nakazato M, Yamano H, Matsushita H, et al. Immunologic fecal occult blood test for colorectal cancer screening. Japan Med Assoc J 2006;49:203-207.
  34. Morikawa T, Kato J, Yamaji Y, et al. Sensitivity of immunochemical fecal occult blood test to small colorectal adenomas. Am J Gastroenterol 2007;102:2259-2264.
  35. Chiu HM, Lee YC, Tu CH, et al. Association between early stage colon neoplasms and false-negative results from the fecal immunochemical test. Clin Gastroenterol Hepatol 2013;11:832-838.
  36. Blakeborough A, Sheridan MB, Chapman AH. Complications of barium enema examinations: a survey of UK Consultant Radiologists 1992 to 1994. Clin Radiol 1997;52:142-148.
  37. Sosna J, Blachar A, Amitai M, et al. Colonic perforation at CT colonography: assessment of risk in a multicenter large cohort. Radiology 2006;239:457-463.