Mu 2017, bungwe la World Health Organization linanena za njira ya"kuzindikira msanga, kuzindikira msanga, ndi kulandira chithandizo msanga", zomwe cholinga chake ndi kukumbutsa anthu kuti azisamalira zizindikiro pasadakhale.Patatha zaka zambiri zachipatala ndalama zenizeni,njira zitatuzi zakhala njira yabwino kwambiri yopewera khansa.
Malinga ndi "Global Cancer Report 2020" yomwe idatulutsidwa ndi WHO, akuti chiwerengero cha khansa yatsopano padziko lonse chidzakwera kufika 30.2 miliyoni mu 2040 ndipo chiwerengero cha imfa chidzafika 16.3 miliyoni.
Mu 2020, padzakhala khansa yatsopano 19 miliyoni padziko lapansi.Panthawiyo, makhansa akuluakulu atatu omwe ali ndi khansa yayikulu kwambiri padziko lonse lapansi ndi awa: khansa ya m'mawere (22.61 miliyoni), khansa ya m'mapapo (2.206 miliyoni), colon (19.31 miliyoni), ndi khansa yapamimba yomwe ili pachisanu ndi 10.89 miliyoni ,mu chiwerengero cha khansa zatsopano, khansa ya m'matumbo ndi khansa ya m'mimba ndi 15.8% ya khansa zonse zatsopano.
Monga tonse tikudziwa, thirakiti la Manhua limatanthawuza kuchokera pakamwa kupita ku chitseko cha utawaleza, chomwe chimaphatikizapo kummero, m'mimba, matumbo aang'ono, matumbo akuluakulu (cecum, appendix, colon, rectum ndi anal canal), chiwindi, kapamba, etc. ndi colorectum mu khansa yatsopano padziko lonse Khansa ndi khansa ya m'mimba onse ndi a m'mimba, choncho khansa yokhudzana ndi m'mimba iyeneranso kutsatiridwa ndipo njira "yatatu oyambirira" iyenera kukhazikitsidwa.
Mu 2020, chiwerengero cha odwala khansa m'dziko langa chinafikanso 4.5 miliyoni, ndipo chiwerengero cha anthu omwe anamwalira ndi khansa chinali 3 miliyoni.Pafupifupi anthu 15,000 ankapezeka ndi khansa tsiku lililonse, ndipo anthu 10.4 ankapezeka ndi khansa mphindi iliyonse.Chachisanu ndi khansa ya m’mapapo(kuwerengera 17.9% ya khansa zonse zatsopano),khansa yapakhungu (12.2%), khansa ya m'mimba (10.5%),khansa ya m'mawere (9.1%), ndi khansa ya chiwindi (9%).Pakati pa khansa zisanu zapamwamba zokha,khansa ya m'mimba ndi 31.7% ya khansa zonse zatsopano.Zitha kuwoneka kuti tifunika kusamala kwambiri kuti tipeze ndi kupewa khansa ya m'mimba.
Zotsatirazi ndi kope la 2020 (kufufuza kwapadera ndi malingaliro opewera chotupa cha Chang Beihui cha anthu) chokhudza kupewa kupweteka kwa m'mimba ndikuwunika:
Khansara ya m'mimba
Zinthu zowopsa kwambiri
1.Asymptomatic anthu opitilira zaka 1.45;
2.Anthu opitilira zaka 240 omwe ali ndi zizindikiro za anorectal kwa milungu iwiri":
3.Odwala ndi zilonda zam'mimba kwa nthawi yayitali;
4.4 anthu pambuyo opaleshoni khansa colorectal;
5. Chiwerengero pambuyo pa chithandizo cha colorectal adenoma;
6. Achibale apamtima omwe ali ndi mbiri ya banja la khansa ya m'mimba
7. Achibale apamtima a odwala omwe adapezeka ndi khansa ya m'matumbo omwe ali ndi zaka zopitilira 20.
Kuwunika Malangizo
1. Kuwunika kwa "General Population" Kukumana 1-5:
(1) Kuyezetsa khansa yapakhungu kumayamba ali ndi zaka 45, mosasamala kanthu za amuna kapena akazi, magazi amatsenga (FOBT) amapezeka kamodzi pachaka.
Colonoscopy zaka 10 zilizonse mpaka zaka 75;
(2) Azaka zapakati pa 76-85, omwe ali ndi thanzi labwino, ndi omwe amakhala ndi moyo wopitilira zaka 10, atha kupitilizabe kukongoletsa.
2 Mogwirizana ndi "Kufufuza kwachipatala kwa achibale omwe ali ndi mbiri yakale ya khansa yapakhungu:
(1) wachibale wa digiri yoyamba ya 1 yemwe ali ndi adenoma yapamwamba kwambiri kapena ululu (zaka zoyambira ndi zosakwana zaka 60), 2
Achibale a digiri yoyamba ndi kupitilira apo omwe ali ndi adenoma yapamwamba kwambiri kapena khansa (m'badwo uliwonse woyambira), kuyambira pazaka 40 (kapena kuyambira zaka 10 kuchepera zaka zakubadwa kwa wachinyamata womaliza), kuyezetsa kwa FOBT kamodzi chaka, kamodzi pa zaka 5 Colonoscopy;
(2) Anthu omwe ali pachiwopsezo chachikulu omwe ali ndi mbiri yabanja la achibale a digiri yoyamba (1 yokha, ndipo zaka zoyambira ndizoposa zaka 60):
Yambani kuyang'ana ali ndi zaka 40, ndikuyesa FOBT chaka chilichonse komanso colonoscopy zaka khumi zilizonse.3 Kuwunika kwa achibale a "khansa yamtundu wa cholowa" 7;
Kwa achibale a odwala omwe ali ndi FAP ndi HNPCC, kuyezetsa kosinthika kwa jini kumalimbikitsidwa pamene kusintha kwa jini koyamba m'banja kumakhala koonekeratu.
(1) Kwa iwo omwe ali ndi mayeso oyesa kusintha kwa majini, akatha zaka 20, colonoscopy iyenera kuchitidwa zaka 1-2 zilizonse;(2) Kwa iwo omwe ali ndi mayeso olakwika a gene mutation, anthu ambiri akuyenera kuwunikidwa.4 Njira zowunikira zowunikira:
(1) Kuyesa kwa FOBT + kufufuza kwapakati pa voliyumu ndiyo njira yayikulu yofufuzira ya Han, ndipo umboni ndi wokwanira:
(2) Kuzindikira magazi omwe ali ndi chibadwa chambiri kungathandize kuwongolera kulondola kwa kuwerengera, ndipo mtengo wake ndi wokwera mtengo;(3) Ngati mikhalidwe ikuloleza, kuyezetsa kumatha kuchitidwa mwa kuphatikiza chopondapo ndi njira zamagazi.
Malangizo oletsa:
1. Kuchita masewera olimbitsa thupi kungathandize kuchepetsa zochitika za zotupa, kutsatira utsogoleri wa masewera, ndi kusambira kuti mupewe kunenepa kwambiri;
2. Chakudya chopatsa thanzi muubongo, onjezerani kudya zakudya zamafuta ochepa komanso zipatso zatsopano, komanso kupewa zakudya zamafuta ambiri komanso zama protein;
3 Mankhwala osatupa komanso oletsa khansa atha kukhala othandiza popewa khansa ya m'matumbo.Okalamba angayesere kumwa aspirin wochepa, zomwe zingachepetse chiopsezo cha matenda a mtima ndi ubongo ndi khansa ya m'matumbo.Funsani dokotala kuti mugwiritse ntchito.
5.Chepetsani kusuta kuti mupewe kuopsa kwake kwanthawi yayitali komanso kukondoweza kotupa kwa Qinghua Dao.
Khansa ya M'mimba
Zinthu zowopsa kwambiri
Aliyense amene ali ndi chimodzi mwa zinthu zotsatirazi ndi chinthu choopsa kwambiri;
1. Zaka zoposa 60;
2 Zolimbitsa thupi komanso zowopsa atrophic gastritis;
3. Chilonda cham'mimba chosatha;
4. Matenda a m'mimba;
5. Chimphona pinda chizindikiro cha chapamimba mucosa;
6. Postoperative yotsalira m`mimba kwa chosaopsa matenda;
7. Otsalira m'mimba pambuyo opaleshoni khansa chapamimba (miyezi 6-12 pambuyo opaleshoni);
8. Helicobacter pylori matenda;
9. Mbiri yomveka bwino ya banja la khansa ya m'mimba kapena yam'mimba;
10. Kuchepa kwa magazi m'thupi:
11. Familial adenomatous polyposis (FAP), khansara ya m'matumbo ya cholowa yosakhala ya polyposis (HNPCC) ya banja.
Kuwunika Malangizo
Zaka zoposa 40 ndi ululu wa m'mimba, kupweteka kwa m'mimba, kupweteka kwa asidi, kutentha kwa mtima ndi zizindikiro zina za kupweteka kwa epigastric, gastritis, gastric mucosal intestinal metaplasia, polyps, m'mimba yotsalira, chizindikiro chachikulu cha m'mimba, zilonda zam'mimba ndi epithelium. Hyperplasia ndi zina zotupa ndi zinthu ndi banja mbiri ya zotupa ayenera kukumana wokhazikika gastroscopy malinga ndi malangizo a dokotala.
Malangizo oletsa
1. Khazikitsani kadyedwe koyenera ndi kadyedwe koyenera, osati kudya mopambanitsa;
2. Kuthetsa matenda a Helicobacter pylori;
3. Chepetsani kudya zakudya zoziziritsa, zokometsera, zotenthedwa, zolimba, komanso zakudya za mchere wambiri monga kusuta ndi kuzifutsa.
4. Siyani kusuta;
5. Imwani moŵa waukali wochepa kapena osaumirira;
6. Pumulani ndikuchepetsani bwino
Khansa yam'mimba
Zinthu zowopsa kwambiri
Zaka> Zaka 40 ndikukumana ndi zifukwa zotsatirazi:
1. Kuchokera kudera lomwe anthu ambiri ali ndi khansa ya m'mero m'dziko langa (dera lomwe lili ndi khansa yam'mimba kwambiri m'dziko lathu lili m'zigawo za Hebei, Henan ndi Shanxi kumwera kwa Phiri la Taihang, makamaka ku Cixian County, ku Qinling, Dabie Mountain, kumpoto kwa Sichuan, Fujian, Guangdong, kumpoto kwa Jiangsu, Xinjiang, ndi zina zotero.
2. Zizindikiro zam'mimba zam'mimba, monga nseru, kusanza, kupweteka kwa m'mimba, kutsekemera kwa asidi, kusapeza bwino ndi zizindikiro zina;
3. Mbiri ya banja la ululu wam'mero:
4. Kudwala matenda am'mero kapena zotupa za precancerous:
5. Kukhala ndi chiopsezo chachikulu cha khansa ya m'mimba monga kusuta, kumwa mowa kwambiri, kunenepa kwambiri, kukonda zakudya zotentha, squamous cell carcinoma ya mutu ndi khosi kapena kupuma;
6. Kudwala matenda a reflux a perisophageal (CERD);
7. Matenda a papillomavirus (HPV).
Kuwunika Malangizo
Anthu omwe ali pachiwopsezo chachikulu cha khansa ya esophageal:
1. Wamba endoscopy, kamodzi zaka ziwiri zilizonse;
2 Endoscopy ndi pathological anapeza wofatsa dysplasia, endoscopy kamodzi pachaka;
3 Endoscopy ndi pathological anapeza zolimbitsa dysplasia, endoscopy miyezi isanu ndi umodzi iliyonse
Malangizo oletsa
1. Osasuta kapena kusiya kusuta;
2. Mowa wochepa kapena osamwa mowa;
3. Idyani chakudya chokwanira, idyani zipatso ndi ndiwo zamasamba zambiri
4. Limbikitsani masewera olimbitsa thupi komanso kukhala ndi thupi labwino;
5. Osadya chakudya chotentha kapena kumwa madzi otentha.
khansa ya chiwindi
Zinthu zowopsa kwambiri
Amuna azaka zopitilira 35 ndi akazi azaka zopitilira 45 m'magulu awa:
1. Matenda a hepatitis B (HBV) osatha kapena matenda aakulu a hepatitis C (HCV);
2. Amene ali ndi mbiri ya banja lawo la khansa ya chiwindi;
3. Odwala ndi chiwindi matenda enaake amayamba ndi likodzo, mowa, pulayimale biliary matenda enaake, etc.;
4. Odwala omwe ali ndi kuwonongeka kwa chiwindi chifukwa cha mankhwala;
5. Odwala omwe anatengera kagayidwe kachakudya matenda, kuphatikizapo: hemochromatosis a-1 antitrypsin akusowa, glycogen yosungirako matenda, kuchedwa porphyria cutaneous, tyrosinemia, etc.;
6. Odwala ndi autoimmune hepatitis;
7. Odwala matenda a chiwindi chamafuta osaledzera (NAFLD).
Kuwunika Malangizo
1. Amuna opitilira zaka 35 ndi amayi opitilira zaka 45 omwe ali pachiwopsezo chotenga khansa ya chiwindi ayenera kufufuzidwa;
2. Kuphatikizika kwa serum alpha-fetoprotein (AFP) ndi chiwindi B-ultrasound, kuyezetsa miyezi isanu ndi umodzi iliyonse.
Malangizo oletsa
1. Katemera wa chiwindi B;
2. Odwala matenda a chiwindi ayenera kulandira mankhwala oletsa tizilombo toyambitsa matenda mwamsanga kuti athetse kubwerezabwereza kwa matenda a chiwindi.
3. Pewani kapena kuchepetsa kumwa mowa;
4. Idyani zakudya zochepa komanso kuchepetsa kudya zakudya zamafuta
5. Pewani kudya zakudya zakhungu.
Khansa ya kapamba
Zinthu zowopsa kwambiri
Anthu azaka zopitilira 40, makamaka azaka zopitilira 50, ali ndi chimodzi mwazinthu izi (chinthu chachisanu ndi chimodzi sichimawonjezera chiopsezo cha khansa ya kapamba, koma kuwunika sikumachitidwa):
1. Mbiri ya banja la khansa ya kapamba ndi shuga;
2. Pali mbiri ya kusuta fodya, kumwa mowa, mafuta ambiri komanso zakudya zamapuloteni kwa nthawi yaitali;
3. Kudzaza kwapakati ndi kumtunda kwa mimba, kusokonezeka, kupweteka kwa m'mimba popanda chifukwa chodziwikiratu, ndi zizindikiro monga kusowa kwa njala, kutopa, kutsekula m'mimba, kutaya thupi, kupweteka kwa msana, etc.;
4. Kubwerezabwereza kwa kapamba kosatha, makamaka kapamba kosatha kokhala ndi miyala ya kapamba, pancreatic duct-type mucinous papilloma, mucinous cystic adenoma, ndi chotupa cholimba cha pseudopapillary, chokhala ndi seramu yokwera CA19-9;
5. Kuyamba mwadzidzidzi kwa matenda a shuga mellitus popanda mbiri ya banja;
6. Helicobacter pylori (HP) zabwino, mbiri ya oral periodontitis, PJ syndrome, etc.
Kuwunika Malangizo
1. Nkhani zomwe tazitchula pamwambapa zimayesedwa ndi zotsatira za mayeso a magazi a zotupa zotupa monga CA19-9, CA125 CEA, etc., kuphatikizapo CT ndi MRI ya m'mimba, ndi B-ultrasound ingaperekenso chithandizo chofanana;
2. Kuyeza kwa CT kapena MR kamodzi pachaka kwa anthu omwe tawatchulawa, makamaka omwe ali ndi mbiri ya mabanja komanso zotupa za kapamba.
Malangizo oletsa
1. Siyani kusuta ndi kuledzera;
2. Limbikitsani chakudya chopepuka, chosavuta kugayidwa, chopanda mafuta;
3. Idyani nkhuku zambiri, nsomba ndi shrimp, ndikulimbikitsa kudya masamba a "+" a maluwa, monga kabichi wobiriwira, kabichi, radish, broccoli, etc.;
4. Limbikitsani masewera olimbitsa thupi panja
5. Pofuna kupewa kuwonongeka kwa zilonda zam'mimba, omwe ali ndi miyala ya pancreatic, intraductal mucinous papilloma ndi cystic adenoma kapena zotupa zina zowopsa za kapamba ayenera kupita kuchipatala munthawi yake.
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Nthawi yotumiza: Sep-09-2022