风险模型与仅便免疫化学试验的诊断收益率:在结直肠癌查计划中的随机对照试验
Tim L Kortlever1,2,3, Manon van der Vlugt1,2,3,4, Floor A M Duijkers5
1Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
British journal of cancer
|July 19, 2023
概括
在荷兰一项试验中,将危险因素添加到便免疫化学测试 (FIT) 中并没有改善结直肠癌 (CRC) 查收益率. 该研究发现,在FIT-only和风险模型组之间检测晚期瘤没有显著差异.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 结肠直肠癌 (CRC) 查旨在早期检测晚期瘤 (AN).
- 便免疫化学测试 (FIT) 是一种常见的查工具.
- 将FIT与风险因素相结合可能会提高CRC查效率.
研究的目的:
- 评估一种风险模型,将FIT结果与人口和生活方式因素结合起来,用于检测AN.
- 为了比较风险模型引导的CRC选臂与FIT-only臂中的AN产量.
- 评估对结肠镜推率和参与率的影响.
主要方法:
- 一项随机对照试验,涉及22,748名年龄在56-75岁的荷兰CRC查计划中的个人.
- 参与者被随机分配到风险模型组 (FIT+问卷) 或仅FIT组.
- 在两组之间比较了先进瘤检测率,对FIT或高风险得分的阳性结肠镜转诊.
主要成果:
- 在这两组中,参与率相似 (27%).
- 在风险模型组 (3.70/1000) 和仅FIT组 (3.43/1000) 之间,晚期瘤的产量没有显著差异.
- 在AN收益率的绝对差异为0.27/1000受邀者 (95%CI:-1.30至1.82,p=0.82).
结论:
- 在这个CRC查计划中,将风险模型与FIT集成并没有增加与FIT单独相比,晚期瘤的检测率.
- 该研究没有证明基于风险的方法对改善查产量的增加价值.
- 干预组和对照组之间没有观察到参与率的显著差异.
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