放射和内镜查以减少胃癌死亡率:系统性审查和元分析
Masaya Hibino1, Chisato Hamashima2, Mitsunaga Iwata1
1Department of Emergency Medicine and General Internal Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
The Lancet regional health. Western Pacific
|July 10, 2023
概括
胃癌查与内镜显著降低死亡率在每协议分析,但效果在这个系统性审查的程序层面上减少.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 之前的系统性审查结合了有偏见的查效应.
- 胃癌查研究通常具有多种设计和固有的偏见.
研究的目的:
- 综合关于无症状成年人胃癌死亡率的比较数据.
- 根据研究设计和干预类型对查效应进行分类,纠正偏差.
主要方法:
- 系统综述和贝叶斯元分析,比较查 (放射/内镜) 与不进行查的研究.
- 包括7项新方案研究和15项观察性研究 (队列/病例控制).
- 用每协议 (PP) 和意向选 (ITS) 效应纠正自选偏差的数据.
主要成果:
- 内镜查显示,PP效应显著降低了胃癌死亡率的风险 (RR 0.52).
- 放射性查没有显示出显著的PP效应 (RR 0.80).
- 两种查方法都没有显示出显著的ITS效应,结果在仅限于东亚研究时是相似的.
结论:
- 观察证据表明,胃癌查可能会降低高发病率地区的死亡率.
- 与个人遵守 (PP) 相比,在计划层面 (ITS) 选效应较少明显.
- 研究质量和偏差校正方法显著影响观察到的查效应.
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