事件记录
面试官: 你是否意识到，每年有很大比例的成年人死于结肠癌是由于缺乏对结直肠癌的了解? 所以这意味着通过今天的播客，你将会降低患结肠直肠癌的风险.
Dr. 普里扬卡·坎斯来自亨茨曼癌症研究所大发娱乐是大发娱乐今天要讨论的要点，以大发娱乐你了解，这样你就不太可能患结直肠癌.
So, 首先, it's one of the most common cancers, and it causes a significant percentage of adult cancer deaths. Colorectal cancer impacts men and women equally. 即使你没有家族史，你也需要进行筛查，当你出现症状时，通常已经太晚了, that's why 筛选 is so important. So let's start with the first one Dr. Kanth, colorectal cancer I didn't realize this, one of the most common cancers and causes a lot of deaths.
Dr. Kanth: 这是正确的. So colon cancer is the third most common cancer in the U.S. 第一名是肺第二名是乳腺和前列腺分别代表性别. And then third is colon cancer, and that's pretty high. And it is also the second most common cancer to cause death in the U.S. So the first is lung cancer, leading the highest deaths from a cancer, and the second is colon cancer. So it is surely that the burden of disease is very high.
面试官: 是的. I think that surprises a lot of people. 很多人没有意识到这一点，因此，他们可能不把筛查当回事. Another misperception is that men . . . It's a man's disease, but it actually impacts men and women equally. 多跟我说说.
Dr. Kanth: 绝对. So there is no separate recommendation for men and women. 男女都可能得这种癌症，而且男女都应该在同样的年龄开始. So there is no difference in recommendation. 它是 a disease for anyone. So anyone should get screened and now at age 45, 是的.
面试官: 另一种看法是，我的家人，没有人得过结肠直肠癌. So I'm probably going to be okay. 也许我不需要在45岁时进行筛查，这是最新的建议. Maybe I can wait till I'm 60. 但这也是错误的.
Dr. Kanth: 绝对, you're very correct about it. 很多时候，大发娱乐不认为这是一个问题，因为大发娱乐家里没有人, 但这是不正确的. 这可能发生在任何人身上. 事实上，70%的结直肠癌患者没有家族史. 这是一个很大的数字. 这就是为什么进行筛查非常重要因为筛查是最好的预防措施.
面试官: 我也明白有一种误解认为结直肠癌只发生在老年人身上, 比如60多岁的时候, 70s, 和80年代, so I can put off my 筛选.
Dr. Kanth: Again, a very, very good point. 这可能发生在任何人身上. 所以年龄是一个数字. 当然，老年人更容易患此病，但即使是年轻人也可能患上此病. And we have seen a rise in incidents in less than age 50. So it is not a disease of only old age. 它是 a disease for anyone to be worried about.
面试官: And then the other misperception that I've heard is, oh, I'll go in and get my 筛选 when I start to show symptoms. But that's very dangerous and inaccurate.
Dr. Kanth: 它是. 这是非常危险的，因为结肠癌，尤其是早期阶段，不会有任何症状. 即使到了晚期你也会出现症状，非常轻微的症状. 这是一种你不会产生症状的疾病，你不会想到它，它就在你体内. So you have to be very, very aware of this. That don't wait for symptoms. Go ahead and get your 筛选.
面试官: 如果病人在出现症状的时候来找你治疗会有多困难?
Dr. Kanth: 绝对. 因此，如果症状已经出现，大发娱乐担心这是一种晚期疾病. 治疗已经扩散到结肠以外的晚期疾病比治疗第一或第二阶段的疾病要困难得多, when it is just in the colon. If it's just in the colon, we take your colon out. We all can live without our colon believe it or not. 大发娱乐可以在生活质量上有所改变，但大发娱乐可以保持同样的预期寿命. 所以治疗早期结肠癌比治疗四期要容易得多, late-stage colorectal cancer, 是的.
面试官: 有两种选择，一种是大便检查，一种是结肠镜检查. Tell me the advantages and disadvantages of each one of those, 因为, 你知道, we know that 45 is the number we should be screened at, but some of us don't necessarily want to take, 你知道, the day off before and after to get a colonoscopy, 跟我说说.
Dr. Kanth: 这是正确的. So colonoscopy is gold standard. 大发娱乐称之为金本位制的原因是，这是大发娱乐唯一可以进入的预防工具, we can see a precancerous lesion, 哪个是息肉, 大发娱乐可以把它拿出来.
面试官: And so it's a diagnostic tool.
Dr. Kanth: 这是一种诊断.
面试官: 此外，如果在同一时间有问题，你可以照顾它.
Dr. Kanth: 你已经处理好了. It will never turn into cancer. Stool test are very, very, very good tests to detect colon cancer. 它们可能检测不出息肉，但能以非常高的灵敏度检测出结肠癌. 所以对于担心结肠镜检查的病人来说这是一个很好的选择. Now, colonoscopies are not without risk. 这是一种侵入性手术. 大发娱乐给你打镇定剂. You have to go through a prep as well. 你需要休息一下, 就像你提到的, 是的, some risks associated with the procedure itself, like bleeding or perforation. Those risks are very small, very, very small, but can happen. Stool tests on the other hand, 非常安全, can detect colon cancer readily, 可能不是息肉, 但它是一个很好的工具, once we find that you have blood in stool. 记住，如果你的粪便测试呈阳性，你必须做结肠镜检查. 这是下一步. 所以要记住, any 筛选 test result like we said, best 筛选 test is the one that gets done. So we should consider 筛选 whatever option works for you.
面试官: And the advantage of a colonoscopy too, 一旦你完成了, if no polyps are discovered, you're good for another 10 years.
Dr. Kanth: 绝对. 如果你准备得好, if you did a good exam and no polyps were found, you have no family history, you don't have to repeat it for 10 years. 所以即使是小息肉现在大发娱乐也不需要在7到10年内重复这个手术. 所以最近的建议改变了，变得更加宽松，即使你有一两个小息肉, 你没事的.
面试官: And the stool test is yearly.
Dr. Kanth: So stool test, there're a couple of stool tests. 一种粪便测试，你每年都要做一次叫做粪便免疫化学测试. The other stool test is called FIT-DNA, 商业上叫做Cologuard，你可以考虑每三年洗一次. 但它肯定比结肠镜检查更频繁.
面试官: 让大发娱乐简单谈谈阻止人们接受这两种筛查的障碍. So maybe we can help talk them through and encourage them, 你知道, if they have average risk to get screened at 45, 因为这是预防结直肠癌死亡的最好方法. So what are some of the barriers and how can people overcome those?
Dr. Kanth: 绝对. So the biggest barrier, I think, is the knowledge. They should know that they have to get screened. So there is a provider and patient education involved either away. 所以如果没有人告诉他们，或者他们没有在收音机里听到，就说他们不知道. So that's the biggest barrier. So education is very important from both aspects. 其他障碍是, I would say another very big barrier is, 当然, 保险责任范围, if you don't have insurance. 但是还有其他的工具，还有其他的方法，就像我说的，粪便测试，它们非常便宜. So things can still be done even if you don't have insurance. 除此之外，其他障碍就是担心做手术. A lot of people think colonoscopy is painful. 我必须经历这一切. 这不是真的. Colonoscopy is a very smooth, painless procedure, honestly. 所以这些事情会伤害到我，这是不对的. So those are the main things. I would say if I have to pick any, I would say education. If you're aware you're going to do it, you will do it.
面试官: And sometimes it's just getting it on the calendar, right?
Dr. Kanth: 绝对.
面试官: 无论是结肠镜检查还是大便检查，都要和你的初级保健医生谈谈. Have that discussion find out where it works out for you.
Dr. Kanth: 绝对. 是的. 这是平均风险筛查，你可以选择任何方法，结肠镜检查或粪便检查. 还有其他测试，其他方式，但这两种是最常见的. 如果你有家族史，大发娱乐建议你做结肠镜检查，这是大发娱乐推荐的常用工具. 所以最好的方法是联系你的初级保健大发娱乐提供者，和他们谈谈什么对你最好.