coloproctology

, Volume 35, Issue 2, pp 151–158

Kolorektales Karzinom

Prävention und Früherkennung
CME Zertifizierte Fortbildung
  • 289 Downloads

Zusammenfassung

Unter allen malignen Erkrankungen ist das Kolonkarzinom in Deutschland nach dem Bronchialkarzinom die zweithäufigste Todesursache. Der zeitliche Ablauf von der Entstehung eines Adenoms und Entwicklung zum Karzinom beträgt etwa 10–15 Jahre. In dieser Zeitspanne ist es möglich, die Vorstufen zum Karzinom durch geeignete Vorsorgeverfahren zu erkennen. Da die Karzinominzidenz in der asymptomatischen Bevölkerung ab dem 50. Lebensjahr ansteigt, werden in Deutschland seit 2002 von den Krankenkassen Vorsorgemaßnahmen übernommen, welche die Erkennung von Vorstufen oder Frühformen des Kolonkarzinoms ermöglichen. Der vorliegende Beitrag gibt einen Überblick über geeignete Maßnahmen zur Prävention und Früherkennung des kolorektalen Karzinoms.

Schlüsselwörter

Stuhltests Sigmoidoskopie Koloskopie CT-Kolonographie Screening 

Colorectal cancer

Prevention and early recognition

Abstract

Colorectal cancer is the second most common cause of death from malignant diseases in Germany after lung cancer. The time lapse from the formation of an adenoma to development of a carcinoma is approximately 10-15 years. In this time period it is possible to recognize the preliminary stages prior to a carcinoma using appropriate screening procedures. Because the incidence of carcinoma in the asymptomatic population increases after 50 years of age, since 2002 screening measures have been introduced by the health insurance companies in Germany which allow recognition of preliminary stages or early forms of colorectal cancer. This article gives a review of suitable measures for prevention and early recognition of colorectal cancer.

Keywords

Fecal tests Sigmoidoscopy Colonoscopy Colonography, computed tomographic Screening 

Literatur

  1. 1.
    Lieberman DA, Weiss DG, Veterans Affairs Cooperative Study Group 380 (2001) One-time screening for colorectal cancer with combined fecal occult-blood test and examination of the distal colon. N Engl J Med 345:555–560Google Scholar
  2. 2.
    Allison JE, Sakoda LC, Levin TR et al (2007) Screening for colorectal neoplasms with new fecal occult blood tests: update on performance characteristics. J Natl Cancer Inst 99:1–9Google Scholar
  3. 3.
    Ahlquist DA, Sargent DJ, Loprinzi CL et al (2008) Stool DNA and occult blood testing for screen detection of colorectal neoplasia. Ann Intern Med 149:441–450PubMedGoogle Scholar
  4. 4.
    Whitlock EP, Lin JS, Liles E et al (2008) Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 149:638–658PubMedGoogle Scholar
  5. 5.
    Hundt S, Haug U, Brenner H (2009) Comparative evaluation of immunochemical fecal occult blood tests for colorectal adenoma detection. Ann Intern Med 129:422–428Google Scholar
  6. 6.
    Haug U, Rhebacher D, Wente MN et al (2007) Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients. Br J Cancer 96:1329–1334PubMedGoogle Scholar
  7. 7.
    Möslein G, Schneider C, Theilmeier A et al (2010) Analysis of the statistical value of various commercially available stool tests – a comparison of one stool sample in correlation to colonoscopy. Dtsch Med Wochenschr 135:557–562PubMedCrossRefGoogle Scholar
  8. 8.
    Itzkowitz SH, Brand R, Jandorf L et al (2008) A simplified, noninvasive stool DNA test for colorectal cancer detection. Am J Gastroenterol 103:2862–2870PubMedCrossRefGoogle Scholar
  9. 9.
    Atkin WS, Edwards R, Kralj-Hans I et al (2010) Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet 375:1624–1633PubMedCrossRefGoogle Scholar
  10. 10.
    Schoen RE, Pinsky PF, Weissfeld JL et al (2012) Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med 366:2345–2357Google Scholar
  11. 11.
    Pox CP, Altenhofen L, Brenner H et al (2012) Efficacy of a nationwide screening colonoscopy program for colorectal cancer. Gastroenterology 142:1460–1467PubMedCrossRefGoogle Scholar
  12. 12.
    Muller AD, Sonnenberg A (1995) Prevention of colorectal cancer by flexible endoscopy and polypectomy: a case-control study of 32,702 veterans. Ann Intern Med 123:904–910PubMedGoogle Scholar
  13. 13.
    Singh H, Turner D, Xue L et al (2006) Risk of developing colorectal cancer following a negative colonoscopy examination. Evidence for a 10-year interval between colonoscopies. JAMA 295:2366–2373PubMedCrossRefGoogle Scholar
  14. 14.
    Baxter NN, Goldwasser MA, Paszat LF et al (2009) Association of colonoscopy and death from colorectal cancer: a population-based, case-control study. Ann Intern Med 150:1–8PubMedGoogle Scholar
  15. 15.
    Brenner H, Hoffmeister M, Arndt V et al (2010) Protection from right and left-sided colorectal neoplasms after colonoscopy: population-based study. J Natl Cancer Inst 102:89–95Google Scholar
  16. 16.
    Zauber AG, Winawer SJ, O’Brien MJ et al (2012) Colonoscopic polypectomy and long-term prevention of colorectal cancer deaths. N Engl J Med 366:687–696Google Scholar
  17. 17.
    Regge D, Laudi C, Galatola G et al (2009) Diagnostic accuracy of computer tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cancer. JAMA 301:2453–2461PubMedCrossRefGoogle Scholar
  18. 18.
    Johnson CD, Chen M-H, Toledano AY et al (2008) Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med 359:1207–1217Google Scholar
  19. 19.
    Zalis ME, Blake MA, Cai W et al (2012) Diagnostic accuracy of laxative-free computed tomographic colonography for detection of adenomatous polyps in asymptomatic adults: a prospective evaluation. Ann Intern Med 156:692–702PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Medizinische Klinik 1Klinikum FriedrichshafenFriedrichshafenDeutschland

Personalised recommendations