结肠镜查与西格莫镜查在结肠直肠癌中的有效性
Frederik E Juul1,2, Amanda J Cross3, Robert E Schoen4
1Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway.
JAMA network open
|February 29, 2024
概括
结肠镜查在降低结肠直肠癌 (CRC) 发病率和死亡率方面提供了额外的好处,与西格米多斯科普相比. 然而,结肠镜检查对西格莫多斯科普的增量益处不如西格莫多斯科普对不进行查的初始益处那么明显.
科学领域:
- 胃肠病学 胃肠病学
- 预防医学 预防医学
- 在瘤学瘤学.
背景情况:
- 随机试验证实,西格莫视镜查降低了结直肠癌 (CRC) 发病率和死亡率.
- 结肠镜已经成为首选的CRC查方法,但长期试验数据有限.
研究的目的:
- 为了估计结肠镜查对抗sigmoidoscopy查对CRC预防的比较有效性.
- 量化结肠镜除了西格米多斯科比之外的额外查益处.
主要方法:
- 一项模拟研究,汇集了358,204名参与者在4个随机的西格莫视镜查试验 (1993-2001) 中的数据.
- 估计的结肠镜疗效通过假设在近端和远端结肠类似的疗效,与挪威试验数据验证.
- 主要结局包括15年随访期间的CRC发病率和死亡率.
主要成果:
- 与通常护理相比,结肠镜查与CRC发病率估计减少30%和CRC死亡率减少32%有关.
- 结肠镜对西格莫镜镜的额外好处是,每10万人/年,结肠镜减少了6.9%的CRC病例和7.6%的CRC死亡.
- 为了防止一个CRC病例,需要从西格莫显微镜转换为结肠镜的数量是560,防止一个CRC死亡的数量是1611.
结论:
- 结肠镜查在CRC发病率和死亡率上提供了额外的预防效果,与西格米多斯科普相比.
- 结肠镜检查对西格米多斯科普的增量好处比西格米多斯科普对不进行查的好处要小.
- 这些发现可能代表了通过从西格米多斯科比切换到结肠镜查来实现的额外益处的上限.
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