广州社区结直肠癌筛查现状

Status quo of colorectal cancer screening in Guangzhou community

营养支持治疗能够改善患者一般情况，是保证手术成功的主要条件之一。加速康复外科（enhanced recovery after surgery，ERAS）通过减轻胃肠手术术后患者应激反应，来缩短术后康复进程。临床营养支持治疗在ERAS中的应用包括手术前进行营养风险评估，对营养不良者进行术前营养治疗；手术当天禁食固体食物和透明液体的时间分别缩短至麻醉诱导前6 h和2 h；术后早期恢复经口进食可以改善患者的临床结局。ERAS的应用使临床营养理念得以拓展和提升，深化了营养支持治疗的作用，有利于患者的康复。

The incidence of colorectal cancer （CRC） in China is gradually increasing as a resuh of the economic development and dietary change. Since it usually takes a long time for precancerous lesions （e.g. adenoma） to develop into cancer, proper cancer screening is useful to discover and to remove these early lesions, while the patients can achieve long-term survival. Hence, developing a well-organized cancer screening system is necessary for the early detection and intervention of potential CRC. Sun Yat-sen University Cancer Center （SYSUCC） has been developing a community-based cancer screening program, using questionnaires and fecal occult blood test to identify the residents with high risks of CRC. These people will be further subjected to colonoscopy and biopsy for the suspected lesions. Among the 1 030 participants in Guangzhou Yuexiu District who received colonoscopy at SYSUCC from January to November in 2015, polyps, inflammation or tumors were found in 361 （35.0%） patients, in whom 13 were colorectal cancers （1.3%）, 327 were polyps （31.7%）, 239 were adenoma （23.2%）, and 140 were prophase adenoma （13.6%）. Besides, no significant difference of CRC detection rate between male and female was found （P 〉 0.05）, while the detection rate of polyps and prophase adenoma was higher in male than that in female, which also increased significantly with age （P 〈 0.01 ）. We envision such systematic cancer screening extremely useful to enhance the understanding of cancer screening in the public and eventually to realize the early detection and treatment of cancer.