ネガティブな検査から3年後,シグモイドスコピーを繰り返した結果
Robert E Schoen1, Paul F Pinsky, Joel L Weissfeld
1Department of Medicine, University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, PA, USA. rschoen@pitt.edu
JAMA
|July 3, 2003
まとめ
フレキシブルシグモイドスコピー (FSG) のスクリーニングは,前期アデノマと遠隔結腸がんを検出する陰性検査の3年後に繰り返します. これらの発見は,結腸直腸がんの予防のためのスクリーニング間隔の延長について懸念を喚起しています.
科学分野:
- 胃腸内科 胃腸内科
- 腫瘍学 腫瘍学
- 予防医学は,予防的な医療です.
背景:
- ネガティブな内視鏡検査後の結腸直腸がんの最適なスクリーニング間隔は不明である.
- 繰り返しスクリーニングの結果を理解することは,効果的なガイドラインの開発に不可欠です.
研究 の 目的:
- 初期陰性スクリーニングの3年後に,リピート・フレキシブル・シグモイドスコピー (FSG) を用いて,遠大腸の腺腫と癌の検出率を評価する.
- 結腸直腸がんのスクリーニングにおける繰り返しFSGの発見の臨床的意義を評価する.
主な方法:
- 前立腺,肺,結腸,卵巣 (PLCO) がんスクリーニング試験,ランダム化制御研究からのデータを活用しました.
- ベースラインのFSGと3年後にFSGを繰り返した参加者を含め,第2回スクリーニングのために9317人が戻った.
- スクリーンで検出された異常に対する診断評価の結果を追跡した.
主要な成果:
- 合計で13.9% (1292/9317) の参加者は,繰り返しFSGで検出されたポリップまたは塊を持っていた.
- 3.1% (292/9317) の個体において,アデノマまたは癌が遠大腸で発見されました.
- 進行性腺腫 (72) または癌 (6) は,0.8% (78/9317) の症例で検出され,進行性病変のほとんどは,以前に検査された領域で見つかりました.
結論:
- ネガティブな検査から3年後に柔軟なシグモイドスコピーを繰り返すことは,進行したアデノマと遠方の結腸癌の検出に効果的です.
- わずかな割合であっても,重大な異常が検出されることは,3年という間隔が,一部の個体にとって長すぎる可能性があることを示唆しています.
- これらの発見は,結腸直腸がん予防戦略における長期スクリーニング間隔の再検討の必要性を強調しています.
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