美国癌症学会增加两项检查作为结肠直肠癌预防和筛检项目
Two Tests Added to Recommended List to Prevent or Detect Colorectal Cancer美国癌症学会增加两项检查作为结肠直肠癌预防和筛检项目
The American Cancer Society and other health groups are recommending two tests they had not previously endorsed to prevent or detect colorectal cancer, the groups said Wednesday.
美国癌症协会周三表示：协会以及其他一些健康组织建议将两项之前未被包括的检查列为结肠直肠爱早期预防筛查的项目。
The new policy is based on evidence that the tests work well enough to recommend and applies to all adults 50 and older and to some younger people with symptoms or risk factors for colon cancer.
这项新政策是建立在一些关于这些检查在50岁及以上人群以及年轻的结直肠癌高危人群中应用后的良好效果上的。
One test is virtual colonoscopy, which uses a CT scan to look for abnormal growths and, unlike the standard colonoscopy, does not require inserting a camera-tipped tube rectally.
一项检查是虚拟肠镜，是利用CT扫描发现肠道内是否有异常物质的生长。与标准肠镜所不同的是，这项检查不需要从肛门插入肠镜。
The other test examines stool to find abnormal DNA associated with cancer and requires an entire bowel movement be packed in a kit and sent to a laboratory.
另一项检查是通过检查粪便中的与肿瘤相关的DNA，这项检查要求收集肠道中所有的粪便并将其送到实验室中。
The tests are now part of a list of seven testing options from which people can choose. The medical groups are providing as many options as possible, they say, hoping patients find one acceptable.
这两项试验目前目前是可供患者选择的7种检查方法中的，医疗机构目前正在想方设法找到更多的检查方法，以使患者能从中作出能够接受的选择。
Colorectal cancer is the second leading cause of cancer death in the United States, with 49,960 deaths and 148,810 new cases expected in 2008.
结直肠癌造成的死亡在美国是所有癌症中的第3位，2008估计：会有49,960死于结直肠癌，并且会有148,810新发病例。
Many people are so squeamish about tests for the disease that they skip them entirely. It is one of the very few cancers that can be entirely prevented by removing polyps or other precancerous growths or can be cured if detected early.
有许多病人对于检查十分的惧怕以至于他们甚至不愿意进行任何的医疗检查。而结直肠癌是癌症中少数能够通过早期的发现切除息肉或者其他的癌前病变达到治愈的癌症。
“Fifty percent of the population gets no screening,” said Dr. Grace H. Elta, a gastroenterologist and professor at the University of Michigan who is president of the American Society for Gastrointestinal Endoscopy. “Any screening is better than that.”
消化科医生Grace H. Elta（Michigan大学教授，美国消化道内镜协会主席）说任何一种影像学检查的应用率都比消化道内镜高，病人中只有50%的人做过消化道内镜检查。
The new guidelines organize the tests in two groups and specify the intervals to perform them.
新的指南将这些检查手段分为两组并且在它们的执行过程中给与了特殊的分界线。
The first group consists of tests that can detect cancer or prevent it by finding precancerous growths. It includes colonoscopy, which examines the entire colon; flexible sigmoidoscopy, which examines part of the colon; barium enemas; and virtual colonoscopy.
第一组包括了那些能够发现癌症或者通过发现癌前病变来预防癌症发生的检查。它包括了可以检查整个结肠的结肠镜，可以检查部分肠道的软性乙状结肠镜，钡灌肠，虚拟肠镜。
The second group primarily detects cancer, rather than preventing it. Two tests look for blood in the stool, and the third is the stool DNA test. Blood in the stool does not necessarily indicate cancer but requires follow-up.
第二组主要是用于以诊断癌症后分析病情时所用，两种检测粪便中是否含有血的试验，第三种是粪便的DNA检测。粪便中发现有血并不一定是癌症，但是需要做进一步的检查。
“Prevention should be the primary goal,” said Dr. Robert Smith, director of screening for the cancer society.
肿瘤影像学会的主席Robert Smith医生说：“预防才是最重要的。”
That would mean that the first group of tests is preferable. But Dr. Smith said some people were unwilling to have them or unable to afford them.
这就表明了第一组检查是更重要的，但是有一些人并不愿意接受这些检查，或者是没有能力支付这些检查的费用。
Right now, Dr. Elta said, insurers do not cover virtual colonoscopy, which she said costs $1,200 to $1,500. It is uncertain whether the new guidelines will lead to coverage changes.
Elta医生说：“目前，医疗保险还没有将虚拟肠镜纳入其中，这项检查的花费在$1,200到 $1,500之间，其被写入指南有可能使其也被纳入医疗保险。”
None of the tests are perfect. Doctors who perform colonoscopy, for instance, may fail to see precancerous lesions. Virtual colonoscopy will probably fail to detect lesions that are flat, a type that is especially risky and more common in the United States than previously realized, researchers reported Tuesday in The Journal of the American Medical Association.
这些检查手段没有一项是完美的。那些偏爱于肠镜的医生也有不能准确识别癌前病变的可能。研究者们在周三发表的美国医学联合会杂志上说虚拟肠镜有可能不能识别那些较平坦的病灶，这种病灶目前在美国的发现率比之前预想的要高很多。
Tests for blood in the stool generally miss polyps and detect just half of tumors. Sigmoidoscopy does not reach the upper stretches of the colon.
检测粪便中是否含有血的试验通常会漏诊那些息肉以及一半的肿瘤。乙状结肠镜则无法看到结肠的上半部分。
As for the stool DNA test, Dr. Elta said, “It’s really not ready for prime time.” The test is not accurate enough, she said, and in many instances not reimbursed by insurers.
关于检测粪便中DNA的试验，Elta医生说：“这项试验还没有达到完美的阶段。它并不足够精确，而且很多保险并未将其纳入。”
“Most people are not using it right now,” she said. “The biggest hope of all is if it ever gets good enough to pick up polyps. It’s the test with the most promise, but right now it has no efficacy at picking up polyps.”
她说：“很多人还没有开始选择这项检查。对于这种检查方法最大的期望是它可以准确检测出息肉，但目前它还不能精确的达到这一目的。”
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