Clinical practice guideline. Diagnosis and prevention of colorectal cancer. 2018 Update
Gastroenterol Hepatol. 2018 Nov;41(9):585-596.
doi: 10.1016/j.gastrohep.2018.07.012.
Epub 2018 Sep 20.
[Article in
English,
Spanish]
Authors
Joaquín Cubiella
1
, Mercè Marzo-Castillejo
2
, Juan José Mascort-Roca
3
, Francisco Javier Amador-Romero
4
, Begoña Bellas-Beceiro
5
, Joan Clofent-Vilaplana
6
, Sabela Carballal
7
, Juan Ferrándiz-Santos
8
, Antonio Z Gimeno-García
9
, Rodrigo Jover
10
, Carolina Mangas-Sanjuán
10
, Leticia Moreira
7
, María Pellisè
7
, Enrique Quintero
9
, Elena Rodríguez-Camacho
11
, Pablo Vega-Villaamil
12
; Sociedad Española de Medicina de Familia y Comunitaria y Asociación Española de Gastroenterología
Affiliations
- 1 Servicio de Aparato Digestivo, Complexo Hospitalario Universitario de Ourense, Instituto de Investigación Sanitaria Galicia Sur, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Ourense, España. Electronic address: joaquin.cubiella.fernandez@sergas.es.
- 2 Unitat de Suport Recerca Metropolitana Sud - IDIAP, Cornellà de Llobregat, Barcelona, España.
- 3 ABS Florida Sud, ICS, Hospitalet de Llobregat, Barcelona, España.
- 4 CS Los Ángeles, Madrid, España.
- 5 Unidad Docente de Atención Familiar y Comunitaria La Laguna-Tenerife Norte, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España.
- 6 Servicio de Gastroenterología, Hospital de Sagunto, Sagunto, Valencia, España.
- 7 Servicio de Gastroenterología, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBEREHD, Barcelona, España.
- 8 Subdirección General de Calidad Asistencial, Dirección General de Humanización, Madrid, España.
- 9 Servicio de Gastroenterología, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Universidad de La Laguna, San Cristóbal de La Laguna, Tenerife, España.
- 10 Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria ISABIAL, Hospital General Universitario de Alicante, Alicante, España.
- 11 Dirección Xeral de Saúde Pública, Santiago de Compostela, Santiago de Compostela, La Coruña, España.
- 12 Servicio de Aparato Digestivo, Complexo Hospitalario Universitario de Ourense, Instituto de Investigación Sanitaria Galicia Sur, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Ourense, España.
Abstract
This document updates the recommendations made by the Spanish Society of Family and Community Medicine and the Spanish Association of Gastroenterology for the diagnosis and prevention of colorectal cancer (CRC). In order to evaluate the quality of the evidence and determine the recommendation levels of the interventions, we used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. This document establishes optimal delay intervals based on symptoms and the faecal immunochemical test (FIT) and recommends reducing the barriers for diagnostic confirmation in symptomatic subjects. With regard to CRC screening in the average-risk population, we propose strategies to achieve the universal implementation of organised CRC screening programmes based on biennial FIT and to increase the participation of the target population, including the involvement of Primary Healthcare. This Clinical Practice Guideline recommends universal screening for Lynch syndrome with mismatch repair proteins immunohistochemistry or microsatellite instability in incident CRCs and the use of gene panels in patients with adenomatous polyposis. It also updates the strategies to reduce the incidence and mortality of both CRC and other tumours associated with hereditary syndromes. Regarding non-hereditary familial CRC and surveillance after resection of adenomas, serrated lesions or CRC, we established the recommendations based on the attributable risk and the risk reduction of the proposed intervention. Finally, the document includes recommendations regarding surveillance intervals in inflammatory bowel disease and the attitude towards dysplasia.
Keywords:
Clinical Practice Guideline; Colonoscopia; Colonoscopy; Colorectal cancer; Cribado poblacional; Cáncer colorrectal; Diagnosis; Diagnóstico; Enfermedad inflamatoria intestinal; Faecal occult blood test; Guía de práctica clínica; Inflammatory bowel disease; Lynch syndrome; Poliposis; Polyposis; Population screening; Prevención; Prevention; Síndrome de Lynch; Test de sangre oculta en heces.
Copyright © 2018 Elsevier España, S.L.U. All rights reserved.
MeSH terms
-
Adenocarcinoma / diagnosis
-
Adenocarcinoma / epidemiology
-
Adenocarcinoma / prevention & control*
-
Adenomatous Polyposis Coli
-
Chemoprevention
-
Colectomy
-
Colonoscopy
-
Colorectal Neoplasms / diagnosis*
-
Colorectal Neoplasms / epidemiology
-
Colorectal Neoplasms / prevention & control*
-
Diet
-
Early Detection of Cancer / standards
-
Humans
-
Inflammatory Bowel Diseases
-
Life Style
-
Neoplastic Syndromes, Hereditary / diagnosis
-
Occult Blood
-
Precancerous Conditions / diagnosis
-
Precancerous Conditions / surgery
-
Risk Factors