for CRC screening that are not recommended by the American Cancer Society or other organizations because of poorer performance. These include in-office stool tests, in which a single-stool sample is collected during a digital rectal exam and placed on an FOBT card, and “toilet bowl tests,” which are over-the-counter guaiac-based tests that are often promoted as a type of FOBT. Despite recommendations against in-office FOBT, some primary care physicians continue to offer the test.255 Toilet bowl tests have not been evaluated in the types of rigorous clinical studies done on the guaiac-based FOBT and FIT. Double-contrast barium enema, also called barium enema with air contrast, is a test that takes an x-ray of the colon after barium sulfate is introduced. This test is no longer recommended because it has lower sensitivity for detecting CRC than other tests. There are also emerging technologies that are not currently recommended for CRC screening because there was insufficient data on their performance compared to other recommended options at the time the guidelines were issued. These include blood-based tests that measure circulating genetic abnormalities associated with colorectal adenomas and cancer, and capsule endoscopy, in which the patient undergoes bowel cleansing and swallows a pill-sized device containing tiny encapsulated cameras that transmit images of the colon and rectum to a recording device. Use of colorectal cancer screening According to the National Health Interview Survey (NHIS), CRC screening in accordance with guidelines increased rapidly among adults ages 50 and older from 2000 (38%) to 2010 (59%), but more slowly in the past decade, reaching 66% in 2018 (Table 5).44 The most recent NHIS data collected in 2018 contain a mix of respondents surveyed before and after the release of the American Cancer Society CRC screening guideline in mid-2018. Approximately 56% of those ≥45 years of age and 21% of those ages 45-49 years reported being up to date with CRC screening in 2018. Among adults ages 50 and older in 2018: • 61% reported having a colonoscopy in the past 10 years, and 3% and 1% reported having a sigmoidoscopy or CT colonography, respectively, in the past 5 years. • Approximately 11% reported a recent stool test; 9% reported an FIT or FOBT in the past year and 3% reported stool DNA testing in the past 3 years.44 Colorectal Cancer Facts & Figures 2020-2022 23 • Screening was lowest among ages 50-54 years (48%); Asian Americans (55%); individuals with less than a high school education (52%); the uninsured (30%); and recent (9 mm in average-risk individuals. Gastroenterology. 2014;147(2):351-358; quiz e314-355. 21. Ferlitsch M, Reinhart K, Pramhas S, et al. Sex-specific prevalence of adenomas, advanced adenomas, and colorectal cancer in individuals undergoing screening colonoscopy. the drug. Material and Method. A rat model of hepatic fibrosis was established via CCl4 induction. Liver function and antioxidant indices were detected using commercial kits. Hematoxylin-eosin and Masson staining were used to detect pathological changes in hepatic tissues. ELISA was used to measure plasma TNF-α, IL-β, and IL-6 levels. RT-PCR was used to measure changes in TNF-α, IL-β, and IL-6 levels in hepatic tissues. Changes in p65, P-p65, Nrf2, and HO-1 protein expression were detected using western blotting. Results. In rats with hepatic fibrosis, Biejiaxiaozheng pills effectively improved liver function, alleviated fibrosis in hepatic tissues, and significantly reduced collagen accumulation. The pills significantly downregulated inflammatory cytokine expression in hepatic tissues by suppressing p65 phosphorylation and reduced plasma inflammatory cytokine levels to some extent. The pills upregulated Nrf2 and HO-1 expression in hepatic tissues, enhanced antioxidant potential, and upregulated plasma antioxidant levels. Conclusion. Biejiaxiaozheng pills improved hepatic fibrosis symptoms and lesions in rats, likely by inhibiting the NF-κB pathway and promoting the Nrf2 pathway Hepatic fibrosis is a type of hepatic pathological change induced by a long-term chronic injury of hepatocytes due to diseases