RESUMO
Cancer is a major cause of morbidity and mortality. Tobacco use, unhealthy diet, and physical inactivity are some of the lifestyle risk factors that have led to an increase in cancer. This article updates the evidence and includes recommendations for prevention strategies for each of the cancers with the highest incidence. These are based on the reduction of risk factors (primary prevention) and early diagnosis of cancer through screening and early detection of signs and symptoms, in medium-risk and high-risk populations. This update of the 2022 PAPPS has taken into account the vision of the National Health System Cancer Strategy, an update approved by the Interterritorial Council of the National Health System on January 2021 and the European Strategy (Europe's Beating Cancer Plan) presented on 4 February 2021.
Assuntos
Neoplasias , Humanos , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Fatores de Risco , Estilo de Vida , Dieta , Programas de RastreamentoRESUMO
Cancer is a major cause of morbidity and mortality. Tobacco use, unhealthy diet, and physical inactivity are some of the lifestyle risk factors that have led to an increase in cancer. This article updates the evidence, and includes recommendations for prevention strategies for each of the cancers with the highest incidence. These are based on the reduction of risk factors (primary prevention) and early diagnosis of cancer through screening and early detection of signs and symptoms, in medium-risk and high-risk populations.
Assuntos
Programas de Rastreamento , Neoplasias , Dieta , Humanos , Estilo de Vida , Neoplasias/diagnóstico , Neoplasias/prevenção & controle , Fatores de RiscoRESUMO
Este documento actualiza las recomendaciones realizadas por la Sociedad Española de Medicina Familiar y Comunitaria y la Asociación Española de Gastroenterología para el diagnóstico y la prevención del cáncer colorrectal (CCR). Para establecer la calidad de la evidencia y los niveles de recomendación de las intervenciones se ha utilizado la metodología basada en el sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation). Este documento establece intervalos de demora óptimos en función de los síntomas y el test de SOH inmunológico (SOHi) y recomienda reducir las barreras para la confirmación diagnóstica en los pacientes con síntomas. En cuanto al cribado en población de riesgo medio, se proponen estrategias para conseguir la implantación universal del cribado poblacional basado en SOHi bienal e incrementar la participación de la población diana, incluyendo la implicación de atención primaria. Esta guía de práctica clínica recomienda el cribado universal del síndrome de Lynch mediante la inmunohistoquímica de las proteínas reparadoras o la inestabilidad de microsatélites en los CCR incidentes y el uso de paneles de genes en los pacientes con poliposis adenomatosas. También actualiza las estrategias para reducir la incidencia y la mortalidad tanto de CCR como de otros tumores asociados a los síndromes hereditarios. En cuanto al CCR familiar no hereditario y la vigilancia tras resección de CCR, adenomas y lesiones serradas, se establecen recomendaciones en función del riesgo atribuible y la reducción del riesgo de la intervención propuesta. Finalmente, en el documento se incluyen recomendaciones respecto a los intervalos de vigilancia en la enfermedad inflamatoria intestinal y la actitud ante la displasia
This document updates the recommendations made by the Spanish Society of Family and Community Medicine and the Spanish Association of Gastroenterology for the diagnosis and prevention of colorectal cancer (CRC). In order to evaluate the quality of the evidence and determine the recommendation levels of the interventions, we used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. This document establishes optimal delay intervals based on symptoms and the faecal immunochemical test (FIT) and recommends reducing the barriers for diagnostic confirmation in symptomatic subjects. With regard to CRC screening in the average-risk population, we propose strategies to achieve the universal implementation of organised CRC screening programmes based on biennial FIT and to increase the participation of the target population, including the involvement of Primary Healthcare. This Clinical Practice Guideline recommends universal screening for Lynch syndrome with mismatch repair proteins immunohistochemistry or microsatellite instability in incident CRCs and the use of gene panels in patients with adenomatous polyposis. It also updates the strategies to reduce the incidence and mortality of both CRC and other tumours associated with hereditary syndromes. Regarding non-hereditary familial CRC and surveillance after resection of adenomas, serrated lesions or CRC, we established the recommendations based on the attributable risk and the risk reduction of the proposed intervention. Finally, the document includes recommendations regarding surveillance intervals in inflammatory bowel disease and the attitude towards dysplasia
Assuntos
Humanos , Neoplasias Colorretais/diagnóstico , Polipose Adenomatosa do Colo/genética , Neoplasias Colorretais Hereditárias sem Polipose/genética , Doenças Inflamatórias Intestinais/prevenção & controle , Neoplasias Colorretais/prevenção & controle , Saúde de Grupos Específicos , Neoplasias Colorretais/epidemiologia , Fatores de Risco , Síndrome de Lynch II/diagnóstico , Síndrome de Lynch II/prevenção & controleRESUMO
This document updates the recommendations made by the Spanish Society of Family and Community Medicine and the Spanish Association of Gastroenterology for the diagnosis and prevention of colorectal cancer (CRC). In order to evaluate the quality of the evidence and determine the recommendation levels of the interventions, we used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. This document establishes optimal delay intervals based on symptoms and the faecal immunochemical test (FIT) and recommends reducing the barriers for diagnostic confirmation in symptomatic subjects. With regard to CRC screening in the average-risk population, we propose strategies to achieve the universal implementation of organised CRC screening programmes based on biennial FIT and to increase the participation of the target population, including the involvement of Primary Healthcare. This Clinical Practice Guideline recommends universal screening for Lynch syndrome with mismatch repair proteins immunohistochemistry or microsatellite instability in incident CRCs and the use of gene panels in patients with adenomatous polyposis. It also updates the strategies to reduce the incidence and mortality of both CRC and other tumours associated with hereditary syndromes. Regarding non-hereditary familial CRC and surveillance after resection of adenomas, serrated lesions or CRC, we established the recommendations based on the attributable risk and the risk reduction of the proposed intervention. Finally, the document includes recommendations regarding surveillance intervals in inflammatory bowel disease and the attitude towards dysplasia.
Assuntos
Adenocarcinoma/prevenção & controle , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Adenocarcinoma/diagnóstico , Adenocarcinoma/epidemiologia , Polipose Adenomatosa do Colo , Quimioprevenção , Colectomia , Colonoscopia , Neoplasias Colorretais/epidemiologia , Dieta , Detecção Precoce de Câncer/normas , Humanos , Doenças Inflamatórias Intestinais , Estilo de Vida , Síndromes Neoplásicas Hereditárias/diagnóstico , Sangue Oculto , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/cirurgia , Fatores de RiscoAssuntos
Neoplasias/prevenção & controle , Atenção Primária à Saúde , Prevenção Primária/métodos , Prevenção Secundária/métodos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/prevenção & controle , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/prevenção & controle , Masculino , Neoplasias/diagnóstico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/prevenção & controle , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/prevenção & controle , Espanha/epidemiologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/prevenção & controleRESUMO
No disponible
Assuntos
Humanos , Promoção da Saúde , Prevenção Primária , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Espanha/epidemiologia , Fatores de Risco , IncidênciaRESUMO
[{"text": "Este documento actualiza las recomendaciones realizadas por la Sociedad Española de Medicina Familiar y Comunitaria y la Asociación Española de Gastroenterología para el diagnóstico y la prevención del cáncer colorrectal (CCR). Para establecer la calidad de la evidencia y los niveles de recomendación de las intervenciones se ha utilizado la metodología basada en el sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation). Este documento establece intervalos de demora óptimos en función de los síntomas y el test de SOH inmunológico (SOHi) y recomienda reducir las barreras para la confirmación diagnóstica en los pacientes con síntomas. En cuanto al cribado en población de riesgo medio, se proponen estrategias para conseguir la implantación universal del cribado poblacional basado en SOHi bienal e incrementar la participación de la población diana, incluyendo la implicación de atención primaria. Esta guía de práctica clínica recomienda el cribado universal del síndrome de Lynch mediante la inmunohistoquímica de las proteínas reparadoras o la inestabilidad de microsatélites en los CCR incidentes y el uso de paneles de genes en los pacientes con poliposis adenomatosas. También actualiza las estrategias para reducir la incidencia y la mortalidad tanto de CCR como de otros tumores asociados a los síndromes hereditarios. En cuanto al CCR familiar no hereditario y la vigilancia tras resección de CCR, adenomas y lesiones serradas, se establecen recomendaciones en función del riesgo atribuible y la reducción del riesgo de la intervención propuesta. Finalmente, en el documento se incluyen recomendaciones respecto a los intervalos de vigilancia en la enfermedad inflamatoria intestinal y la actitud ante la displasia.", "_i": "es"}, {"text": "This document updates the recommendations made by the Spanish Society of Family and Community Medicine and the Spanish Association of Gastroenterology for the diagnosis and prevention of colorectal cancer (CRC). In order to evaluate the quality of the evidence and determine the recommendation levels of the interventions, we used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. This document establishes optimal delay intervals based on symptoms and the faecal immunochemical test (FIT) and recommends reducing the barriers for diagnostic confirmation in symptomatic subjects. With regard to CRC screening in the average-risk population, we propose strategies to achieve the universal implementation of organised CRC screening programmes based on biennial FIT and to increase the participation of the target population, including the involvement of Primary Healthcare. This Clinical Practice Guideline recommends universal screening for Lynch syndrome with mismatch repair proteins immunohistochemistry or microsatellite instability in incident CRCs and the use of gene panels in patients with adenomatous polyposis. It also updates the strategies to reduce the incidence and mortality of both CRC and other tumours associated with hereditary syndromes. Regarding non-hereditary familial CRC and surveillance after resection of adenomas, serrated lesions or CRC, we established the recommendations based on the attributable risk and the risk reduction of the proposed intervention. Finally, the document includes recommendations regarding surveillance intervals in inflammatory bowel disease and the attitude towards dysplasia.", "_i": "en"}]
Assuntos
Humanos , Neoplasias Retais/prevenção & controle , Neoplasias Retais/terapia , Gastroenterologia/organização & administração , Síndromes Neoplásicas Hereditárias/genética , ImunoquímicaRESUMO
No disponible
Assuntos
Humanos , Detecção Precoce de Câncer/métodos , Neoplasias/prevenção & controle , Padrões de Prática Médica , Promoção da Saúde , Prevenção Primária , Fatores de RiscoRESUMO
The aim of this study was to evaluate the Spanish population's knowledge of and beliefs regarding the European Code Against Cancer (ECAC) recommendations. This was a cross-sectional, observational, multicentric study that used self-administered surveys. Ten individuals, between the ages of 15 and 69 years old, were enrolled by each participating primary care professional in their respective surgery consultations. This study used 2058 individuals who were recruited by 205 professionals from 106 health centres. Their average age was 41.5 years (52.2% women). The majority believe that smoking [94.1%; 95% confidence interval (CI): 93.1-95.2], sun exposure (91%; 95% CI: 89.7-92.3) and alcoholism (72.1%; 95% CI: 70.1-74.1) are factors related to cancer. The least relevant are infection by the hepatitis B virus (25.7%; 95% CI: 23.8-27.7) and having multiple sexual partners (25%; 95% CI: 23.1-26.9). In all, 86.7% (95% CI: 85.2-88.2) had never heard about the ECAC. Patients adequately identify the carcinogenic effect of tobacco, alcohol or sun exposure. Moreover, they inadequately identify having hepatitis B and multiple sexual partners as being related to cancer. A large majority of individuals have not heard of the ECAC, which raises the need to conduct outreach campaigns at an institutional level and/or through scientific associations and activities promoting health education among primary care professionals.
Assuntos
Guias como Assunto , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias/prevenção & controle , Adolescente , Adulto , Idoso , Alcoolismo , Estudos Transversais , Europa (Continente) , Comportamento Alimentar , Feminino , Hepatite B , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade , Comportamento Sedentário , Comportamento Sexual , Parceiros Sexuais , Fumar , Espanha , Luz Solar , Adulto JovemAssuntos
Neoplasias/prevenção & controle , Neoplasias da Mama/prevenção & controle , Neoplasias Colorretais/prevenção & controle , Feminino , Humanos , Neoplasias Pulmonares/prevenção & controle , Masculino , Neoplasias/diagnóstico , Neoplasias da Próstata/prevenção & controle , Neoplasias Cutâneas/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controleRESUMO
No disponible
Assuntos
Humanos , Neoplasias/prevenção & controle , Prevenção Primária/organização & administração , Lesões Pré-Cancerosas/diagnóstico , Detecção Precoce de Câncer/métodos , Promoção da Saúde/organização & administração , Atenção Primária à Saúde/organização & administração , Estilo de Vida , Exposição AmbientalAssuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , 25580/ética , Monitoramento Epidemiológico/normas , Monitoramento Epidemiológico , Neoplasias da Mama/etiologia , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/radioterapia , 25580/análise , 25580/métodosRESUMO
Colorectal cancer (CRC) is the leading cause of all new cancer cases and the second major cause for all cancer deaths in Spain. CRC survival has improved over the past few decades and is now higher than the 5-years European average, but this is associated with improved treatment than to early detection. A number of screening pilot programs have been completed in various regions, likely leading to national implementation in the future. Treatment guidelines have been developed and implemented to set standards and reduce practice variability. Newer treatments are available, including laparoscopic surgery, adjuvant chemotherapy and the use of targeted treatments. Specific programs are in place for rural patients, as well as programs to reduce waiting times. Overall, Spain is aware of the issues raised by CRC oncology management and has acted to improve patient outcomes, adding screening to its arsenal will further impact survival rates.