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结直肠癌查:科学综述 结直肠癌查:科学综述
Judith M E Walsh1, Jonathan P Terdiman
1Division of General Internal Medicine, Department of Medicine, Women's Health Clinical Research Center, University of California San Francisco, Campus Box 1793, 1635 Divisadero Suite 600, San Francisco, CA 94115, USA. Jwalsh@medicine.ucsf.edu
JAMA
|March 14, 2003
概括
定期的结直肠癌查显著降低了死亡率. 有证据支持各种查方法,如便隐性血液检测和结肠镜检查,但对于50岁及以上的平均风险人群,没有任何单一的测试是绝对优越的.
科学领域:
- 胃肠病学 胃肠病学
- 预防医学 预防医学
- 在瘤学瘤学.
背景情况:
- 结肠直肠癌 (CRC) 查降低了死亡率,但查率仍然低于最佳水平.
- 存在不同的查方式,专业组织的建议各不相同.
- 临床医生在确保查遵守和指导符合条件的患者选择测试方面面临挑战.
研究的目的:
- 批判性地评估支持各种结肠直肠癌查测试的证据.
- 评估既定和新兴查技术的有效性.
主要方法:
- 在PubMed的综合文献搜索,元分析和参考列表 (1966-2002).
- 包括对健康个体的CRC查研究的研究与临床结果评估.
- 随机对照试验的证据优先考虑,其次是观察性和诊断性准确性研究.
主要成果:
- 便隐性血液检测 (FOBT) 通过RCT证明了CRC发病率和死亡率的降低.
- 在病例对照研究中,西格莫视镜显示死亡率降低;观察数据表明结肠镜的有效性.
- 结合FOBT和西格莫视镜可能会提高死亡率的降低和诊断产量.
结论:
- 强有力的证据支持对50岁及以上的个人进行常规结肠直肠癌查.
- 目前的证据并不支持一种查测试对其他平均风险人群.
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