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Fang JY, Zheng S, Jiang B, et al. Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China. Gastrointest Tumors. 2014;1(2):53-75doi: 10.1159/000362585.
Fang, J. Y., Zheng, S., Jiang, B., Lai, M. D., Fang, D. C., Han, Y., Sheng, Q. J., Li, J. N., Chen, Y. X., & Gao, Q. Y. (2014). Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China. Gastrointestinal tumors, 1(2), 53-75. https://doi.org/10.1159/000362585
Fang, Jing-Yuan, et al. "Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China." Gastrointestinal tumors vol. 1,2 (2014): 53-75. doi: https://doi.org/10.1159/000362585
Fang JY, Zheng S, Jiang B, Lai MD, Fang DC, Han Y, Sheng QJ, Li JN, Chen YX, Gao QY. Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China. Gastrointest Tumors. 2014 Jun;1(2):53-75. doi: 10.1159/000362585. Epub 2014 May 09. PMID: 26672726; PMCID: PMC4645581.
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Gastrointest Tumors. 2014 Jun;1(2):53-75. doi: 10.1159/000362585. Epub 2014 May 09.

Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China.

Gastrointestinal tumors

Jing-Yuan Fang, Shu Zheng, Bo Jiang, Mao-De Lai, Dian-Chun Fang, Ying Han, Qian-Jiu Sheng, Jing-Nan Li, Ying-Xuan Chen, Qin-Yan Gao

Affiliations

  1. Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China ; Shanghai Institute of Digestive Disease, Shanghai, China ; Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai, China ; State Key Laboratory of Oncogene and Related Genes, Shanghai Jiaotong University, Shanghai, China.
  2. Key Laboratory of Cancer Prevention and Intervention of China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences of Zhejiang Province, Cancer Institute, Hangzhou, China ; Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
  3. Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
  4. Department of Pathology and Pathophysiology, Zhejiang University School of Medicine, Hangzhou, China.
  5. Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China.
  6. Department of Gastroenterology, General Hospital of Beijing Military Area, Beijing, China.
  7. Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

PMID: 26672726 PMCID: PMC4645581 DOI: 10.1159/000362585

Abstract

BACKGROUND: Colorectal cancer (CRC) is steadily increasing in China. Colorectal adenoma (CRA) is the most important precancerous disease of CRC. Screening for colorectal tumors can aid early diagnosis. Advances in endoscopic mucosal resection and endoscopic submucosal dissection can aid the early treatment of colorectal tumors. Furthermore, because of high risk of recurrence after removal of adenomas under endoscopy, factors contributing to recurrence, the follow-up mode and the interval established, and the feasibility of application and the time of various chemical preventions should be concerned. However, a relevant consensus on the screening, early diagnosis and treatment, and prevention of colorectal tumors in China is lacking.

SUMMARY: The consensus recommendations include epidemiology, pathology, screening, early diagnosis, endoscopic treatment, monitoring and follow-up, and chemoprevention of colorectal tumors in China.

KEY MESSAGE: This is the first consensus on the prevention, screening, early diagnosis and treatment of CRA and CRC in China based on evidence in the literature and on local data.

PRACTICAL IMPLICATIONS: Through reviewing the literature, regional data and passing the consensus by an anonymous vote, gastroenterology experts from all over China launch the consensus recommendations in Shanghai. The incidence and mortality of CRC in China has increased, and the incidence or detection rate of CRA has increased rapidly. Screening for colorectal tumors should be performed at age 50-74 years. Preliminary screening should be undertaken to find persons at high risk, followed by colonoscopy. A screening cycle of 3 years is recommended for persistent interventions. Opportunistic screening is a mode suitable for the current healthcare system and national situation. Colonoscopy combined with pathological examination is the standard method for the diagnosis of colorectal tumors. CRA removal under endoscopy can prevent CRC to some extent, but CRA has an obvious recurrence trend. The follow-up interval after the removal or surgery of colorectal tumors should be different with lesions. Primary prevention of CRA includes improved diet with more fiber, supplements containing calcium and vitamin D, supplements containing folic acid for those with low hemoglobin levels, and cessation of tobacco smoking. Non-steroidal anti-inflammatory drugs and selective cyclooxygenase-2 inhibitors have been recognized to prevent recurrence after adenoma removal.

Keywords: Colorectal tumors; Early diagnosis; Prevention; Screening; Treatment

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