老年人发病的炎症性肠病是否会增加结肠直肠癌的风险? 一个系统性审查和元分析
Mohammad Zamani1, Shaghayegh Alizadeh-Tabari1
1Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713135, Iran.
患有炎症性肠病 (IBD) 的老年患者不会面临患结直肠癌 (CRC) 的风险增加. 这次系统性审查没有发现任何显著的关联,这表明对于这一群体来说,可能不需要例行密集的CRC查.
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:
- 炎症性肠病 (IBD) 与年轻成年人结直肠癌 (CRC) 风险增加有关.
- IBD对老年人CRC风险的影响尚不清楚.
- 关于IBD老年患者CRC风险的知识差距存在.
研究的目的:
- 系统地审查和分析IBD的老年患者中CRC的风险.
- 为了确定IBD是否会增加60岁及以上个体的CRC风险.
- 为了解决老年IBD患者中CRC发病率的不确定性.
主要方法:
- 在2023年8月31日之前对Embase,PubMed和Scopus进行全面的文献搜索.
- 包括基于人群的队列研究,比较老年IBD患者 (≥60岁) 与非IBD患者的CRC风险.
- 使用随机效应模型进行元分析,以计算 95% 置信区间 (CI) 的聚合相对风险 (RR).
主要成果:
- 分析了三项队列研究,涉及35,187名患者和694例CRC事件.
- 在老年人发病的IBD中没有发现CRC风险显著增加 (RR = 1.17 [95% CI: 0.86-1.47]).
- 这一发现适用于克罗恩病 (RR = 1.28 [95% CI: 0.88-1.69]) 和性结肠炎 (RR = 0.99 [95% CI: 0.90-1.09]).
结论:
- 患有IBD的老年患者没有显著增加发生CRC的风险.
- 对所有患有IBD的老年患者进行密集的CRC查可能是不必要的.
- 进一步的研究可能会完善对这一群体的查策略.
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