Publication: Evaluación de la colonoscopia como método de cribado de cáncer colorrectal en población de riesgo aumentado-alto
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2017-10-05
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Universidad Complutense de Madrid
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Abstract
El cáncer colorrectal (CCR) es uno de los problemas de salud más importantes en la actualidad debido a su elevada incidencia y mortalidad y al consiguiente consumo de recursos sanitarios. La mayoría de los CCR se consideran esporádicos y aparecen en individuos sin ningún antecedente familiar ni personal de neoplasias colorrectales; alrededor del 5% corresponden a formas hereditarias, ya sean síndromes polipósicos o no polipósicos y el 20- 25% restante presenta una agregación familiar sin que se haya identificado un componente hereditario bien establecido (CCR familiar). La determinación del riesgo individual de desarrollar un CCR es fundamental para establecer una estrategia adecuada de cribado. Según la edad, antecedentes personales y familiares se distinguen cuatro grandes grupos de riesgo: a) población de riesgo bajo (Individuos menores de 50 años sin antecedentes personales ni familiares de adenomas colorrectales, pólipos serrados o CCR); b) población de riesgo intermedio (individuos asintomáticos mayores de 50 años, sin antecedentes personales ni familiares de adenomas colorrectales, pólipos serrados o CCR); c) población de riesgo elevado (individuos con antecedentes personales de adenomas y/o pólipos serrados colorrectales, enfermedad inflamatoria intestinal, o cáncer colorrectal, o bien antecedentes familiares de cáncer colorrectal sin criterios clínicos ni moleculares de síndromes hereditarios), y d) población de alto riesgo (familias con síndromes hereditarios en los que se han identificado los genes relacionados)...
Colorectal cancer (CRC) is one of the most important health problems today because of its high incidence and mortality and the consequent use of health resources. Most of the RACs are considered sporadic and occur in individuals with no family or personal history of colorectal neoplasms; about 5% are hereditary forms, whether or not polyposis polyposis syndromes and the remaining 20-25% has a familial aggregation without having identified a hereditary component well established (familial CRC). The determination of the individual risk of developing CRC is essential to establish an appropriate screening strategy. By age, personal and family history four main risk groups are distinguished: a) low-risk population (individuals under 50 years with no personal or family history of colorectal adenomas, serrated polyps or CRC); b) intermediate-risk population (asymptomatic individuals over 50 years with no personal or family history of colorectal adenomas, serrated polyps or CRC); c) high-risk population (individuals with a history of adenomas and / or serrated colorectal polyps, inflammatory bowel disease, or colorectal cancer or family history of colorectal cancer either no clinical or molecular criteria inherited syndromes), and d) high population risk (families with hereditary syndromes in which related genes have been identified), The population increased / high risk presented higher frequency of adenomas, advanced adenomas and colorectal cancer compared with the group of mediumrisk population, so it is obliged to implement screening and surveillance programs primarily through endoscopic techniques...
Colorectal cancer (CRC) is one of the most important health problems today because of its high incidence and mortality and the consequent use of health resources. Most of the RACs are considered sporadic and occur in individuals with no family or personal history of colorectal neoplasms; about 5% are hereditary forms, whether or not polyposis polyposis syndromes and the remaining 20-25% has a familial aggregation without having identified a hereditary component well established (familial CRC). The determination of the individual risk of developing CRC is essential to establish an appropriate screening strategy. By age, personal and family history four main risk groups are distinguished: a) low-risk population (individuals under 50 years with no personal or family history of colorectal adenomas, serrated polyps or CRC); b) intermediate-risk population (asymptomatic individuals over 50 years with no personal or family history of colorectal adenomas, serrated polyps or CRC); c) high-risk population (individuals with a history of adenomas and / or serrated colorectal polyps, inflammatory bowel disease, or colorectal cancer or family history of colorectal cancer either no clinical or molecular criteria inherited syndromes), and d) high population risk (families with hereditary syndromes in which related genes have been identified), The population increased / high risk presented higher frequency of adenomas, advanced adenomas and colorectal cancer compared with the group of mediumrisk population, so it is obliged to implement screening and surveillance programs primarily through endoscopic techniques...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 03/02/2016