对结肠直肠癌的查:美国预防服务工作组的最新证据报告和系统审查
Jennifer S Lin1, Leslie A Perdue1, Nora B Henrikson1
1Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon.
JAMA
|May 18, 2021
概括
结肠直肠癌 (CRC) 查选择有效降低死亡率. 便免疫化学测试 (FIT) 和灵活的半导体镜显示强有力的证据减少CRC死亡,而结肠镜带有穿孔等风险.
科学领域:
- 癌症学
- 预防医学
- 胃肠病学
背景情况:
- 结肠直肠癌是美国的主要死亡原因.
- 有效的查方法对于早期检测和减少死亡率至关重要.
研究的目的:
- 系统地审查结肠直肠癌查的有效性,测试准确性和危害.
- 提供美国预防服务工作组指导方针的证据.
主要方法:
- 对MEDLINE,PubMed和Cochrane控制试验中央注册表进行系统审查 (2015年1月至2019年12月,监测至2021年3月).
- 在无症状,一般风险人群中包括英语研究.
- 两个独立的审查者进行数据提取和元分析,以获得公平或优质的研究.
主要成果:
- 灵活的西格镜查降低了CRC特异性死亡率 (IRR,0. 74).
- 便隐性血液测试 (gFOBT) 和便免疫化学测试 (FIT) 也降低了CRC死亡率.
- 对于癌症检测,FIT和便DNA的敏感性和特异性高于gFOBT;结肠镜检测带有穿孔和出血的风险.
结论:
- 有多种结肠直肠癌查方法,它们的有效性,准确性和危害性各不相同.
- 有证据支持灵活的半导体镜和FIT可降低CRC死亡率.
- 查方法的选择应考虑其已证明的益处和潜在的危害.
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