護理師正在教導一組中年成人關於大腸直腸癌篩檢。根據標準指引，平均風險的病人應從幾歲開始篩檢？
A nurse is teaching a group of middle-aged adults about colorectal cancer screening. According to standard guidelines, at what age should a client at average risk begin screening?
- A55 years old55歲
- B35 years old35歲
- C45 years old✓ 正解45歲
- D65 years old65歲
大腸直腸癌是高度可預防的癌症，篩檢的起始年齡是健康促進的重要知識點。根據最新的美國預防服務工作組（USPSTF）以及美國癌症協會（ACS）指引，對於一般風險（無家族史、無相關腸道疾病）的成年人，篩檢起始年齡已從 50 歲下調至 45 歲。這是因為近年來中青年族群發病率有上升趨勢。篩檢方式可包括大腸鏡（每 10 年一次）或糞便免疫化學檢驗（FIT，每年一次）。選項 B 太早，除非有強大遺傳背景；A 和 D 則太晚，會錯失發現早期瘜肉（Precancerous polyps）的機會。臨床思路上，護理師應及時更新知識庫，因為指引的變動會直接影響社區篩檢衛教的族群覆蓋範圍。
Colorectal cancer is a highly preventable malignancy, and the recommended age to begin screening is an important health-promotion teaching point. According to the latest U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) guidelines, screening for average-risk adults (no family history and no related bowel disease) should now begin at age 45 rather than 50, because incidence has been rising in younger and middle-aged adults. Screening methods include colonoscopy (every 10 years) or fecal immunochemical testing (FIT, annually). Option B is too early unless there is a strong genetic background; options A and D are too late and would miss the chance to detect precancerous polyps early. Clinically, nurses must keep their knowledge updated, since guideline changes directly affect the population coverage of community-based screening education.
美國 USPSTF 於 2021 年正式將建議年齡降至 45 歲。台灣目前國民健康署提供的公費大腸癌篩檢（FIT 檢查）對象仍為 50-74 歲。護理師需注意，考 NCLEX 時應遵循美國 45 歲的標準，但在台灣臨床執業則需依照國健署現行政策。