国立がんスクリーニングプログラムにおけるFIT陽性後のコロノスコピーの診断性能
Hyoung Il Choi1, Yunjin Joanne Yum, Hyewon Yang
1Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Republic of Korea.
Medicine
|February 13, 2026
まとめ
男性と標準便免疫化学検査 (FIT) のカットオフは,結腸直腸がんのスクリーニングで進行性腫瘍のリスクを増加させる. 大腸内視鏡検査の完了は,特にFIT検査の結果が陽性である男性にとって極めて重要です.
科学分野:
- 胃腸内科 胃腸内科
- 腫瘍学 腫瘍学
- 公衆衛生は公衆衛生である.
背景:
- 韓国の国立がん検診プログラムは,50歳以上の個人に対して毎年,糞便免疫化学検査 (FIT) を実施しています.
- 進行性腫瘍 (AN) の検出におけるFITの有効性を評価することは,スクリーニング戦略の最適化に不可欠です.
研究 の 目的:
- 陽性FITの後にコロノスコピーの診断性能を評価する.
- FIT検査の結果が陽性であった参加者における進行性腫瘍 (AN) の有病率 (PR) を決定する.
- この集団におけるANに関連する要因を特定する.
主な方法:
- 国立がん検診プログラム (2007-2024) のデータを遡及的に分析した.
- FIT検査の結果が陽性であった参加者を含め,性別,年齢,FITのカットオフ値,および貧血に基づいてANの流行を比較した.
- 多変量分析により,ANの独立した予測要因を特定する.
主要な成果:
- 合計2,445人の参加者がFIT検査で陽性であったが,50.6%が結腸鏡検査を受けた.
- ANのポジティブな予測値は15.4%でした.
- ANの罹患率は男性 (PR=1.8) と標準FITカットオフ (PR=1.9) で著しく高かった. 男性の性別と標準的なFITカットオフは,独立してANと関連していました.
結論:
- 進行性腫瘍は,男性と,韓国のスクリーニングプログラムで標準的なFITカットオフを使用するときにより一般的です.
- 大腸内視鏡検査の完了率が低い (50.6%) は,アデバーンスを改善する戦略の必要性を強調しています.
- 標準的なカットオフを使用してFITの陽性結果を持つ男性および個人に,コロノスコピーの完了のための標的の推奨が保証されています.
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