事件记录
面试官: 过去是50. 现在是45，这是有原因的. Huntsman Cancer Institute and University of Utah Health says more lives can be saved if men and women who are at average risk of colorectal cancer get screened at 45 instead of 50 years old. Dr. 要不是Kanth来自亨茨曼癌症研究所. 为什么要改变？? 发生了什么事?
Dr. Kanth: 从90年代中期到2000年初, 大发娱乐注意到风险增加了, 发病率增加, 和死亡率. 实际上这两个. 所以结直肠癌的病例和死亡人数都在增加. 这就是人们开始研究它的主要原因, researchers started looking into it and came up with this studies, 建模研究. 这就是为什么这个建议被改变了.
面试官: 是的. And the reason that's so important is because unlike other disease that perhaps might show symptoms, 然后你会去接受治疗. 这不是结直肠癌的表现. 筛查确实是拯救生命的最佳方式.
Dr. Kanth: 绝对. 你说得很对. So most of the early onset cancers or any colorectal cancer, early stages do not produce symptoms. 息肉通常是从息肉开始的, which is a little bump in the colon and it changes into colon cancer. These polyps do not produce symptoms and they grow slowly, and you will never know you have one. 这就是结直肠癌最大的问题. 当你出现症状的时候，已经很晚了. 所以筛查是预防这种癌症的最佳策略.
面试官: And this new research has just really shown that people between 45 and 49 because catching it early is the best defense that a lot of good can be done by having it at 45.
Dr. Kanth: 绝对. 绝对. There are certain research which has shown that there was a drastic increase even between age 49 and 50. So one study showed that there was an increase of almost 46% between age 49 and 50. So if we decrease it from 50 to 45, we are really hoping to capture that colon cancer patient. And this would be very, very beneficial between that age group.
The other thing I would like to say that this is also an incentive, 从50岁到55岁增加筛查还有一个好处, 50 to 54. But traditionally, it has been on the lower side if you do it from 50 to 75. There's slightly decreased screening rates in screening uptake between age 50 to 55. So this will help patients who are thinking about it at age 50, but did not get it till age 55. Now they're like, "Oh, you have to get it done at 45, let's get it one at by age 48.“大概是这样. 这在这一点上很有用.
面试官: Is there a perception that colorectal cancer is an older person's disease?
Dr. Kanth: 是的. 我认为大发娱乐很多人, a lot of our patients in general public we think cancer is an old person's disease, 尤其是结肠直肠癌. 现在不是这样了. 这仍然是正确的. Most colorectal cancer will still be diagnosed when you're older, but there has been a rise in patients who are younger than age 50. Some of it is because of genetic causes, but the rise has been in the average risk. 所以这种看法应该改变. 大发娱乐应该把45当作新的50，现在就开始筛查.
面试官: 实际上，45岁是最重要的数字. 不是说我有家族病史? 不是我有症状吗? It's not am I a man or a woman and think I'm less likely to get it. 一旦任何人达到平均风险年龄45岁, 这是导火索，你应该去检查一下.
Dr. Kanth: 绝对. 非常正确的. 所以50是 . . . the same recommendation was for anyone, any gender, male, female. 任何50岁的人，都应该去做个结肠镜检查. 现在这个数字变成了45. 所以你有没有症状并不重要, 你应该去检查一下, 尤其是如果你没有家族史的话. 如果你有家族史，那就是另一回事了. If you don't have family history or average risk, please go get checked at age 45.
面试官: How is this going to impact those that do have an increased risk? 不是平均风险，而是更高的风险? Does that also drop their age that they should go in down or do we know?
Dr. Kanth: So, at this point, if you have a family history, we usually start screening early. 大多数情况下，大发娱乐从40岁开始筛查. Or if somebody had colon cancer, I'd say whatever age, 10 years before they had colon cancer. 所以这可能不会有太大的改变. It's possible we can look at the data and that may change again, 但是在这一点上, 这一建议仅适用于平均风险. 所以家族史是不同的患者群体. That is still a very good point for primary care physician for all of us to ask that history from patients, “你有结肠癌家族史吗？?" Because your risk might be very different from the average risk.
面试官: So have that conversation if you're above average risk with your physician, 你的大发娱乐提供者决定了你是否应该早点接受治疗.
Dr. Kanth: 绝对. 是的.
面试官: 好吧. 至于建议，结肠镜检查可以吗? The home stool test, is that impacted by this age going down to 45?
Dr. Kanth: 最好的筛查是已经完成的. So that's another message which has to be delivered by providers. 结肠镜检查并不是唯一的筛查方法. Colonoscopy is gold standard because you can see the polyps you can remove it before it turn into cancer. But there are other very, very good stool tests which can detect colon cancer easily. They are non-invasive, you stay at home, you don't have any logistics around it. 这些都是很好的测试. So that's a big message which everyone should know that colonoscopy is not the only way to detect cancer. There are other very good stool tests, which everyone should consider. If you're declining colonoscopy for any reason, do go for a stool test.
面试官: So if it's a stool test or if it's the colonoscopy, it doesn't matter. 现在的平均风险是45.
Dr. Kanth: 绝对.
面试官: 好吧. 也, 我理解医疗保险的新建议, 医疗补助计划, and also your commercial insurance will cover either one of those screenings starting at 45.
Dr. Kanth: 是正确的. And that's what we believe after the new recommendation which has been endorsed by pretty much all the societies that all these should be now covered under preventive care just that how we had it at age 50. Even now, some insurances are already covering at age 45, but that was more sporadic. 所以现在大发娱乐期望它100%被覆盖.