護理師指導一位 55 歲客戶關於結直腸癌的一級預防。下列哪項建議最合適？
A nurse is teaching a 55-year-old client about primary prevention of colorectal cancer. Which recommendation is most appropriate?
- AIncrease daily intake of dietary fiber and vegetables✓ 正解增加每日膳食纖維和蔬菜的攝取量
- BUndergo annual fecal occult blood testing接受每年的糞便潛血檢測
- CPerform a digital rectal exam annually每年進行直腸指診
- DSchedule a screening colonoscopy every 10 years每 10 年安排一次篩檢用結腸鏡檢查
一級預防（Primary Prevention）的核心在於阻止疾病的發生。結直腸癌的風險與飲食習慣高度相關，高纖維飲食能促進腸道蠕動，減少致癌物質與腸黏膜接觸的時間，從而降低罹癌風險。其他選項（D、B、C）均屬於二級預防（Secondary Prevention），即透過篩檢在無症狀期發現潛在病變，而非預防疾病本身發生。在臨床護理中，衛教應將生活型態調整置於疾病預防的首位，以達到長期的健康促進。
Primary prevention of colorectal cancer focuses on lifestyle modifications, such as increasing dietary fiber and vegetable intake, to promote bowel health and reduce cancer risk. Screening methods like fecal occult blood testing, digital rectal exams, and colonoscopies are considered secondary prevention strategies used to detect existing disease rather than prevent its initial occurrence.
台美在結直腸癌篩檢指引上大致一致。美國預防服務工作小組（USPSTF）建議 45 歲起應開始定期篩檢。台灣國健署則提供 50-74 歲民眾每兩年一次免費糞便潛血檢查。護理師需根據當地政策與個案風險（如家族史）提供衛教。