結腸直腸がんの予防に役立つ柔軟なシグモイドスコーピーのスクリーニング:多センターランダム化対照試験
Wendy S Atkin1, Rob Edwards, Ines Kralj-Hans
1Department of Surgery and Cancer, Imperial College London, London, UK. w.atkin@imperial.ac.uk
Lancet (London, England)
|May 1, 2010
まとめ
55歳から64歳の成人のための単一の柔軟なシグモイドスコーピーのスクリーニングは,大腸がんの発生率と死亡率を大幅に低下させます. この安全で実用的な検査は,病気に対する長期的な保護を提供します.
科学分野:
- 腫瘍学 腫瘍学
- 予防医学は,予防的な医療です.
- 胃腸内科 胃腸内科
背景:
- 結腸直腸がん (CRC) は,世界中でがん関連の死亡の主な原因です.
- 効果的なスクリーニング戦略は,早期発見と予防に不可欠です.
- この研究では,特定の年齢層における単一の柔軟なシグモイドスコーピーのスクリーニングの長期的な影響を調査しています.
研究 の 目的:
- CRCの発生率と死亡率を低減するために,一度の柔軟なシグモイドスコーピーのスクリーニングの有効性を評価する.
- このスクリーニングメソッドの長期的な利益と安全性を評価する.
- 1人のCRC症例または死亡を防ぐためにスクリーニングを必要とする個人の数を決定する.
主な方法:
- イギリスの14のセンターで17万人を超える参加者を含む大規模なランダム化制御試験です.
- 参加者は,柔軟なシグモイドスコーピーのスクリーニングを受けるか,またはコントロールグループに入るためにランダムに割り当てられました.
- 主なアウトカムには,CRCの発生率と死亡率,治療意図とプロトコル分析が含まれていました.
主要な成果:
- フレキシブルシグモイドスコーピーのスクリーニングは,治療意図分析でCRCの発生率を23%,死亡率を31%低下させた.
- プロトコル毎の分析では,スクリーニング対象者の間で発生率が33%低下し,死亡率が43%低下したことが示されました.
- ディスタルCRCの発生率の有意な50%の減少が観察されました. 1件のCRCの診断または死亡を防ぐためにスクリーニングに必要な数は,それぞれ191件,489件でした.
結論:
- フレキシブルシグモイドスコピーは安全で実用的なスクリーニングツールです.
- 55歳から64歳までの年齢で提供される単一のスクリーニングは,CRCを減らす上で実質的で持続的な利点を提供します.
- この介入は,CRCの予防における公衆衛生のための貴重な戦略です.
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