在性结肠炎中的结肠直肠癌:一个基于斯堪的纳维亚人口的队列研究
Ola Olén1, Rune Erichsen2, Michael C Sachs3
1Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden.
Lancet (London, England)
|January 14, 2020
概括
患有性结肠炎 (UC) 的患者面临更高的结肠直肠癌 (CRC) 和CRC死亡风险. 虽然诊断进展缓慢,风险正在下降,但仍需要改善UC患者的监测指南.
科学领域:
- 胃肠病学
- 癌症学
- 流行病学
背景情况:
- 性结肠炎 (UC) 是结肠直肠癌 (CRC) 的已知危险因素.
- 之前的研究经常使用过时的治疗/监测数据,并没有完全考虑诸如领先时间和监测偏差等偏差.
- 需要考虑到瘤阶段和阶段调整后的死亡率来评估UC患者的CRC风险.
研究的目的:
- 在性结肠炎 (UC) 患者中比较结肠直肠癌 (CRC) 发病率和死亡率的整体和特定国家的风险.
- 评估UC患者的CRC风险,同时考虑瘤阶段和潜在偏差.
主要方法:
- 在丹麦和瑞典 (1969-2017) 进行的基于人口的队列研究,包括96,447名UC患者和949,207名匹配对照.
- 使用国家患者选择登记册和考克斯回归来计算CRC发病率和死亡率的危险比率 (HRs).
- 在诊断时调整瘤阶段的分析.
主要成果:
- 与对照组相比,UC患者的CRC发病率增加了1.66倍,CRC死亡率增加了1.59倍.
- 患有UC的患者被诊断为较不发达的CRC (p<0.0001).
- 经过阶段调整的分析证实,UC患者的CRC死亡风险增加 (HR 1. 54),随着时间的推移,过度风险下降.
结论:
- 患有UC的个体有明显增加的CRC发展和死亡的风险,尽管早期的诊断.
- 在日历期间,UC患者的CRC发病率和死亡率过高的风险有所降低.
- 对UC患者的国际监测指南需要进一步改进以减轻CRC风险.
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