食管、胃及结直肠癌早筛早诊早治专家建议（2025年，上海）

Expert recommendations on early screening, diagnosis, and treatment of esophageal, gastric, and colorectal cancers (2025, Shanghai)

摘要:

食管癌、胃癌及结直肠癌作为严重威胁我国人民健康的三大消化道恶性肿瘤，其防治面临高发病率与早诊率偏低等严峻挑战。为切实提升早筛早诊早治水平，降低发病率和死亡率，国家消化系统疾病临床医学研究中心、国家消化内科专业医疗质量控制中心及免疫与炎症全国重点实验室牵头，组织多领域专家形成本建议。建议聚焦三大癌种早筛早诊早治关键公共卫生与临床问题，系统提出优化筛查策略、推动技术创新应用、强化诊疗质控标准、规范内镜下治疗及随访策略等核心建议，旨在为各级医疗机构提供科学指引，推动我国消化道肿瘤防治体系的高质量发展。 国家卫生健康主管部门立足国情和癌症流行趋势，制定了一系列系统性防治策略，相关学术组织持续颁布并更新规范化诊疗指南。历经数十年发展，我国在食管癌、胃癌及结直肠癌防治领域取得显著成效：部分癌种发病率呈现下降趋势，患者生存率持续改善。然而对标国际先进水平，我国消化道肿瘤防治仍面临特殊挑战——食管癌和胃癌发病率持续处于全球高位，结直肠癌发病率呈现逐年攀升态势。当前制约防治水平提升的关键因素突出体现在基础研究创新不足、高新技术临床应用滞后、基层诊疗同质化程度偏低、优质医疗资源分布不均、专业人才培养体系待完善等方面。如何通过顶层设计优化资源配置，聚焦重点，瞄准难点，解决堵点，是提高我国消化道恶性肿瘤防治效果的关键环节。 在此背景下，藉“2025消化道癌早筛、早诊、早治高质量发展学术论坛”召开之际，国家消化系统疾病临床医学研究中心、国家消化内科专业医疗质量控制中心及免疫与炎症全国重点实验室牵头，组织国内相关领域的数十名著名专家，通过循证研究系统梳理我国消化道恶性肿瘤防治体系的现存短板。聚焦食管癌、胃癌及结直肠癌防治全链条，从筛查策略优化、诊疗技术革新、质控体系完善等维度形成具有临床推广价值的建议。本建议经过多轮专家论证和修订，旨在为各级医疗机构提供科学指引，以期推进我国消化道肿瘤诊疗水平的高质量发展，切实增进全民健康福祉。

Abstract:

Esophageal cancer, gastric cancer, and colorectal cancer, as the three major malignant gastrointestinal tumors that seriously threaten the health of the Chinese population, pose severe challenges to the prevention and treatment due to their high incidence rates and relatively low early diagnosis rates. To effectively enhance the levels of early screening, diagnosis, and treatment, and thereby reduce both incidence and mortality rates, National Clinical Research Center for Digestive Diseases, National Gastroenterology Quality Improvement System, and National Key Laboratory of Immunity and Inflammation have taken the lead in organizing experts from multiple fields to formulate these recommendations. Focusing on key public health and clinical questions of early screening, diagnosis, and treatment in these three cancer types, the recommendations systematically put forward core suggestions, including optimizing screening strategies, promoting the application of technological innovations, strengthening quality control standards for diagnosis and treatment, and standardizing endoscopic treatment and follow-up strategy. The aim is to provide scientific guidance for medical institutions at all levels and drive the high-quality development of gastrointestinal tumor prevention and treatment system in China.