Different standards for healthy screenees than patients in routine clinics?

作     者：Geir Hoff 

作者机构：Department of Research and Development Telemark Hospital Cancer Registry of Norway Institute of Health and Society University of Oslo 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第46期

页      面：8527-8530页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Colonoscopy Screening Quality assurance Standards 

摘      要：Less than 5%of colorectal adenomas will become malignant,but we do not have sufficient knowledge about their natural course to target removal of these5%***,95%of polypectomies are a waste of time exposing patients to a small risk of ***,a new type of polyps,sessile serrated polyps,has attracted *** considered innocuous,they are now found to have molecular similarities to cancer and some guidelines recommend to have them *** lesions are often flat,covered by mucous,not easily seen and situated in the proximal colon where the bowel wall is ***,polypectomy carries a higher risk of perforation than predominantly left-sided,stalked adenomas-and we do not know what is gained in terms of cancer *** is a neat balance between harms and benefit for presumptively healthy participants not interested in risk exposure to obtain confirmation of being *** situation is quite different for patient worried about ***,the standards set for evidence-based practice may be higher for screening than for routine clinics-a mechanism which may benefit patients in the long run.