Detección y vigilancia pospolipectomía de pólipos colónicos
DOI:
https://doi.org/10.52787/agl.v52i1.157Palabras clave:
Pólipos de colon, vigilancia pospolipectomía, tasa de detección de adenomas, cáncer de colon en jóvenes, cáncer colorrectal en la ArgentinaResumen
El cáncer colorrectal es uno de los principales tumores que afecta a la población mundial. Suele tener una lesión precursora, que son los pólipos colónicos (adenomas y serratos). Su prevención se basa en el tamizaje de la población de riesgo promedio (edad 50-75 años, asintomática y sin antecedentes) y en la identificación de grupos de riesgo. La polipectomía endoscópica es efectiva para reducir la incidencia de cáncer colorrectal y su mortalidad. La tasa de detección de adenomas es un claro marcador de calidad de la colonoscopía y se correlaciona con la incidencia del cáncer de colon de intervalo y la mortalidad por cáncer colorrectal. En los últimos años, se han producido cambios importantes para mejorar la detección de pólipos colónicos, así como actualizaciones de las guías de vigilancia pospolipectomía a partir de nuevos estudios de cohorte. La calidad y los hallazgos de la colonoscopía basal constituyen aspectos claves para la vigilancia. Por otro lado, nuevas guías de los Estados Unidos recomiendan el inicio del cribado a los 45 años a partir de datos de cambios epidemiológicos de las últimas décadas, aunque esta recomendación no es seguida por otros países. El objetivo de este manuscrito es realizar una revisión no sistemática sobre cómo mejorar la detección de pólipos colónicos, la edad de inicio y la finalización del cribado y analizar las nuevas guías de vigilancia pospolipectomía. Además, se contextualizan estas recomendaciones para la Argentina, y se mencionan los ensayos clínicos en curso que pueden mejorar la calidad de la evidencia científica actual.
Citas
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