在45岁以下的成年人中,与晚期结肠直肠瘤相关的危险因素
Jacquelyn Bolwell1, Robert Butler2, Carol A Burke1,3,4,5
1Department of Gastroenterology and Hepatology.
Journal of clinical gastroenterology
|January 16, 2024
概括
45岁以下的年轻人有结直肠癌 (CRC),糖尿病或使用烟草的家族史,面临更高的晚期瘤的风险. 建议在具有这些风险因素的人群中提前对CRC进行查.
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) 发病率在年轻成年人 (20-49岁) 中正在增加.
- 目前的CRC查指南建议在平均风险人群中,从45-49岁开始查.
- 确定年轻人 (<45岁) 晚期瘤的危险因素对于有针对性的查至关重要.
研究的目的:
- 确定与45岁以下成年人晚期结直肠瘤相关的因素.
- 为年轻人群提供CRC查策略的潜在调整信息.
主要方法:
- 对13006名年龄在18-44岁之间的患者进行了回顾性分析,这些患者在2011-2021年期间接受了结肠镜检查.
- 排除患有炎症性肠病或遗传性CRC综合征的患者.
- 多变量后勤回归以确定先进瘤的预测因子,将病例与对照进行比较 (正常结肠镜检查).
主要成果:
- 在13006名患者中,5% (651) 患有晚期瘤 (AN),包括腺瘤和结直肠癌 (CRC).
- 与AN显著相关的因素包括年龄,吸烟,糖尿病,非白人种族,较高的BMI和较低的维生素D水平.
- 多变量分析确定年龄的增加,男性性别,吸烟,家族CRC病史,阿司匹林使用和糖尿病作为AN的独立预测因素.
结论:
- 年龄,男性性别,吸烟,家族病史,糖尿病和阿司匹林使用独立地与45岁以下成年人的晚期瘤有关.
- 针对性早期的CRC查在年轻成年人中,这些已识别的风险因素可能是合理的.
- 需要进一步的大规模前性研究来验证这些发现,并完善查建议.
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