Muna 2017, World Health Organisation yakaronga zano re"kuonekwa kwekutanga, kuongororwa kwekutanga, uye kurapwa kwekutanga", iyo inotarisirwa kuyeuchidza veruzhinji kuti vateerere zviratidzo pachine nguva.Mushure memakore emari yekiriniki chaiyo,nzira nhatu idzi dzave nzira inoshanda yekudzivirira cancer.
Sekureva kwe “Global Cancer Report 2020” yakaburitswa neWHO, zvinofungidzirwa kuti huwandu hwegomarara hutsva pasi rose huchakwira kusvika pamamiriyoni makumi matatu nemazana maviri muna2040 uye huwandu hwevanhu vanofa huchasvika 16.3 miriyoni.
Muna 2020, kuchange kuine mamiriyoni gumi nemapfumbamwe egomarara pasi rose.Panguva iyoyo, magomarara matatu makuru ane huwandu hukuru hwekenza pasirese ndeiyi: gomarara rezamu (22.61 miriyoni), kenza yemapapu (2.206 miriyoni), colon (19.31 miriyoni), uye gastric cancer iri pachishanu ne10.89 miriyoni.muhuwandu hwemagomarara matsva, gomarara remudumbu uye gomarara remudumbu rakaita 15.8% yekenza nyowani.
Sezvatinoziva tose, turakiti reManhua rinoreva kubva pamuromo kusvika kumusuwo wemuraraungu, unosanganisira gurokuro, dumbu, ura hudiki, ura hombe (cecum, appendix, colon, rectum uye anal canal), chiropa, pancreas, nezvimwewo. uye colorectum mumakenza matsva pasi rese Kenza negomarara remudumbu ese ari emudumbu, saka magomarara ane chekuita nemudumbu anodawo kutariswa uye zano re "matatu ekutanga" rinofanira kuitwa.
Muna 2020, huwandu hwekenza nyowani munyika yangu dzakasvikawo 4.5 miriyoni, uye huwandu hwevakafa negomarara hwaive mamirioni matatu.Avhareji yevanhu 15,000 vakaonekwa vaine kenza zuva rega rega, uye vanhu gumi nemazana mana vakaonekwa vaine kenza miniti yega yega.Cheshanu igomarara remapapu(inoverengera 17.9% yekenza nyowani),colorectal cancer (12.2%), gastric cancer (10.5%),kenza yemazamu (9.1%), uye kenza yechiropa (9%).Pakati pemagomarara mashanu epamusoro chete,gomarara remudumbu rakaita 31.7% yemagomarara matsva ese.Zvinogona kuonekwa kuti tinofanira kubhadhara zvakanyanya pakuonekwa nekudzivirira kwegomarara rekudya.
Inotevera ndiyo 2020 edition (yakakosha kuferefeta uye kurudziro yekudzivirira yevanhu Chang Beihui tumor) inosanganisira digestive turakiti kudzivirira kurwadziwa uye chirongwa chekuongorora:
Colorectal cancer
High-ngozi zvinhu
1.Asymptomatic vanhu vanopfuura makore 1.45;
2.Vanhu vanopfuura 240 vane anorectal zviratidzo kwemavhiki maviri":
3.Varwere vane ulcerative colitis kwenguva yakareba;
4.4 vanhu mushure mekuvhiyiwa kwegomarara remukati;
5. Huwandu hwevanhu mushure mekurapa colorectal adenoma;
6. Hama dzepedyo dzine nhoroondo yemhuri yegomarara remukati
7. Hama dzepedyo dzevarwere vakawanikwa vaine nhaka yegomarara remukati vane makore anopfuura makumi maviri
Screening Recommendations
1. "General Population" Kuongorora Kunosangana 1-5:
(1) Kuongororwa gomarara remukati kunotanga pazera remakumi mana nemashanu, zvisinei nekuti murume kana mukadzi, fecal occult ropa (FOBT) rinoonekwa kamwe pagore.
Colonoscopy makore ose kusvika 75 makore;
(2) Avo vane makore 76-85, vane utano hwakanaka, uye avo vane tarisiro youpenyu inopfuura makore 10, vanogona kuramba vachichengeta kushongedzwa.
2 Zvinoenderana ne "Kuongororwa kwekiriniki kwenhengo dzemhuri dzepedyo dzine nhoroondo yemhuri yegomarara remukati:
(1) 1 yekutanga-dhigirii hama ine chokwadi chepamusoro-giredhi adenoma kana kurwadziwa (zera rekutanga risingasviki makore makumi matanhatu), 2
Vekutanga-dhigirii hama uye pamusoro vane chokwadi chepamusoro-giredhi adenoma kana kenza (chero zera rekutanga), kutanga pazera remakumi mana (kana kutanga pamakore gumi kubva pazera rekutanga kwemudiki wemhuri), kuongororwa kweFOBT kamwe chete gore, kamwe chete pamakore mashanu Colonoscopy;
(2) Zvidzidzo zvepamusoro zvine nhoroondo yemhuri yehama dzekutanga-degree (chete 1, uye zera rekutanga rakakwirira kupfuura makore makumi matanhatu):
Tanga kutarisa pazera remakumi mana, nebvunzo yeFOBT gore rega rega uye colonoscopy makore gumi ega ega.3 Kuongororwa kwenhengo dzemhuri ye "hereditary colorectal cancer" musangano 7;
Kune nhengo dzemhuri dzevarwere vane FAP neHNPCC, gene mutation test inokurudzirwa kana gene mutation mune yekutanga nyaya mumhuri yajeka.
(1) Kune avo vane positive gene mutation test, mushure memakore makumi maviri, colonoscopy inofanira kuitwa makore ose 1-2;(2) Kune avo vane negative gene mutation test, huwandu hwevanhu hunofanirwa kuongororwa.4 Inokurudzirwa nzira dzekutarisa:
(1) Kuongororwa kweFOBT + kuferefeta kwepakati-vhoriyamu ndiyo nzira huru yekuferefeta kwaHan, uye humbowo hwakakwana:
(2) Kuongororwa kwemajini akawanda eropa kunogona kubatsira kuvandudza kurongeka kwekuverenga, uye mutengo unodhura;(3) Kana mamiriro ezvinhu achibvumira, kuongorora kunogona kuitwa nekubatanidza stool uye nzira dzeropa.
Zano rekudzivirira:
1. Kudzidzira muviri kunogona kunyatso kuderedza kuitika kwemamota, kuomerera kuhutungamiri hwemitambo, uye kushambira kuti udzivise kufutisa;
2. Zvokudya zveuropi zvine utano, kuwedzera kudya kwefiber uye michero mitsva, uye kudzivisa kudya kwemafuta uye mapuroteni akawanda;
3 Non-body anti-inflammatory and anticancer mishonga inogona kushanda mukudzivirira gomarara remuura.Vakwegura vanogona kuedza aspirin yakaderera, iyo inogona kuderedza njodzi yehutano hwemwoyo uye cerebrovascular uye kenza yemuura.Bvunza chiremba kuti unyatsoshandisa.
5.Kuderedza kusvuta kuti udzivise huturu hwayo kwenguva refu uye kukurudzirwa kwekuputika kuQinghua Dao.
Gomarara remudumbu
High-ngozi zvinhu
Chero ani ane imwe yeiyi inotevera mamiriro chinhu chine njodzi huru;
1. Anopfuura makore makumi matanhatu;
2 Pakati uye yakaoma atrophic gastritis;
3. Chisingaperi gastric ulcer;
4. Mudumbu polyps;
5. Giant peta chiratidzo chegastric mucosa;
6. Postoperative residual dumbu kune zvirwere zvisina kunaka;
7. Dumbu rakasara mushure mekuvhiyiwa kenza yemudumbu (6-12 mwedzi mushure mekuvhiyiwa);
8. Helicobacter pylori chirwere;
9. Nhoroondo yemhuri yakajeka yegomarara remudumbu kana esophageal;
10. Pernicious anemia:
11. Familial adenomatous polyposis (FAP), nhaka isiri-polyposis colon cancer (HNPCC) nhoroondo yemhuri.
Screening Recommendations
Zera> 40 makore ane marwadzo emudumbu, dumbu redumbu, acid regurgitation, kupisa kwemoyo uye zvimwe zviratidzo zveepigastric kusagadzikana, uye chisingaperi gastritis, gastric mucosal intestinal metaplasia, gastric polyps, dumbu rakasara, giant gastric fold sign, chisingaperi gastric ulcer uye gastric epitheli. Hyperplasia uye mamwe maronda uye zvinhu zvine nhoroondo yemhuri yemamota zvinofanirwa kuita gastroscopy nguva dzose maererano nekurudziro yechiremba.
Mazano ekudzivirira
1. Gadzira madyiro ane hutano uye chimiro chekudya, kwete kudyisa;
2. Kupedzwa kwechirwere cheHelicobacter pylori;
3. Deredza kudyiwa kwezvikafu zvinotonhora, zvinonhuwirira, zvinopisa zvakapfurikidza, uye zvakaomarara, pamwe chete nezvokudya zvine munyu wakawanda zvakadai sekuputa nekukangwa.
4. Rega kusvuta;
5. Inwa doro rakaoma kana kuti kwete;
6. Zorora uye decompress zvine musoro
Gomarara resophageal
High-ngozi zvinhu
Zera> 40 makore uye kusangana nechero yeinotevera njodzi zvinhu:
1. Kubva munzvimbo ine chiitiko chegomarara resophageal munyika yangu (nzvimbo yakaomesesa yegomarara resophageal munyika yangu iri mumatunhu eHebei, Henan neShanxi kumaodzanyemba kweTaihang Mountain, kunyanya muCixian County, muQinling, Dabie Mountain, kuchamhembe kweSichuan, Fujian, Guangdong, kuchamhembe kweJiangsu, Xinjiang, nezvimwe.
2. Upper gastrointestinal zviratidzo, zvakadai sokunyunyutira, kurutsira, kurwadziwa kwepamuviri, acid regurgitation, kudya kusagadzikana uye zvimwe zviratidzo;
3. Nhoroondo yemhuri yekurwadziwa esophageal:
4. Kutambura kubva esophageal precancerous chirwere kana precancerous maronda:
5. Iva nengozi yakawanda yekenza yeguroguro yakadai sekusvuta, kunwa zvakanyanya, kuwandisa, kufarira zvokudya zvinopisa, squamous cell carcinoma yemusoro nemutsipa kana kufema turakiti;
6. Kutambura ne perisophageal reflux chirwere (CERD);
7. Human papillomavirus (HPV) chirwere.
Screening Recommendations
Vanhu vari panjodzi huru yekenza yesophageal:
1. Ordinary endoscopy, kamwe chete makore maviri oga oga;
2 Endoscopy ine pathological kuwanikwa kwenyoro dysplasia, endoscopy kamwe pagore;
3 Endoscopy ine pathological kuwanikwa kwepakati dysplasia, endoscopy mwedzi mitanhatu yega yega
Mazano ekudzivirira
1. Usasvuta kana kurega kusvuta;
2. Doro shoma kana kusarimwa doro;
3. Idya zvokudya zvine musoro, idya michero nemiriwo minyoro yakawanda
4. Wedzera maekisesaizi uye chengetedza uremu hune hutano;
5. Usadye chikafu chinopisa kana kunwa mvura inopisa.
kenza yechiropa
High-ngozi zvinhu
Varume vane makore anopfuura makumi matatu nemashanu uye vakadzi vanopfuura makore makumi mana nemashanu mune chero anotevera mapoka:
1. Chisingaperi hepatitis B virus (HBV) chirwere kana chisingaperi hepatitis C virus (HCV) utachiona;
2. Avo vane nhoroondo yemhuri yegomarara rechiropa;
3. Varwere vane chiropa chechiropa chinokonzerwa neschistosomiasis, doro, primary biliary cirrhosis, nezvimwewo;
4. Varwere vane zvinodhaka-induced chiropa kukuvara;
5. Varwere vane zvirwere zvakagarwa nhaka, kusanganisira: hemochromatosis a-1 antitrypsin kushomeka, glycogen kuchengetedza chirwere, kunonoka cutaneous porphyria, tyrosinemia, nezvimwewo;
6. Varwere vane autoimmune hepatitis;
7. Kwete-doro mafuta ane chiropa chirwere (NAFLD) varwere
Screening Recommendations
1. Varume vanopfuura makore makumi matatu nemashanu nevakadzi vanopfuura makore makumi mana nemashanu vane njodzi huru yegomarara rechiropa vanofanira kuongororwa;
2. Kusanganiswa kweserum alpha-fetoprotein (AFP) nechiropa B-ultrasound, kuongororwa mwedzi mitanhatu yega yega.
Mazano ekudzivirira
1. Mushonga weHepatitis B;
2. Varwere vane hepatitis isingaperi vanofanira kuwana antiviral therapy nekukurumidza sezvinobvira kudzora kudzokorora kwehutachiona hwehepatitis.
3. Rega kana kuderedza kunwa doro;
4. Idya kudya kwakareruka uye kuderedza kudya kwemafuta ane mafuta
5. Rega kudya chikafu chine chakuvhe.
Pancreatic cancer
High-ngozi zvinhu
Vanhu vane makore anopfuura makumi mana, kunyanya pamusoro pemakore makumi mashanu, vaine chero chimwe chezvinhu zvinotevera (chinhu chechitanhatu hachiwedzere njodzi yegomarara repancreatic, asi kuongororwa hakuwanzo kuitwa):
1. Nhoroondo yemhuri yekenza yepancreatic uye chirwere cheshuga;
2. Pane nhoroondo yekusvuta kwenguva refu, kunwa, mafuta akawanda uye kudya kweprotein;
3. Pakati nepamusoro pedumbu rakazara, kusagadzikana, kurwadziwa kwepamuviri pasina chikonzero chakajeka, uye zviratidzo zvakadai sokurasikirwa kwechido, kuneta, manyoka, kuora muviri, kurwadziwa kwepashure, nezvimwewo;
4. Zvikamu zvakadzokororwa zvechirwere chisingaperi chisingaperi, kunyanya chirwere chisingaperi chine pancreatic duct stones, main pancreatic duct-type mucinous papilloma, mucinous cystic adenoma, uye yakasimba pseudopapillary tumor, ine serum yakakwirira CA19-9;
5. Zvichangobva kuitika zvechirwere cheshuga mellitus pasina nhoroondo yemhuri;
6. Helicobacter pylori (HP) yakanaka, nhoroondo ye oral periodontitis, PJ syndrome, nezvimwewo.
Screening Recommendations
1. Zvidzidzo zvakataurwa pamusoro apa zvinoongororwa nemigumisiro yeropa rekuongorora zviratidzo zvechirwere zvakadai seCA19-9, CA125 CEA, nezvimwewo, zvakasanganiswa neAbdominal CT uye MRI, uye B-ultrasound inogonawo kupa rubatsiro runoenderana;
2. CT kana MR kuongororwa kamwe chete pagore kune vanhu vataurwa pamusoro apa, kunyanya avo vane nhoroondo yemhuri uye maronda epancreatic aripo.
Mazano ekudzivirira
1. Rega kusvuta uye kudzora doro;
2. Kurudzira chikafu chakareruka, chinogayiwa nyore, chine mafuta mashoma;
3. Idya dzimwe huku, hove uye shrimp, uye kukurudzira kushandiswa kwe "+" miriwo yemaruva, yakadai segreen cabbage, kabichi, radish, broccoli, nezvimwewo;
4. Kurudzira zviitiko zvekunze zveaerobic
5. Kuti udzivise kuparara kwezvipembenene zvisingabatsiri, avo vane pancreatic duct matombo, intraductal mucinous papilloma uye cystic adenoma kana zvimwe zvipembenene zvepancreatic zvinofanira kutsvaga kurapwa nenguva.
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Nguva yekutumira: Sep-09-2022