第一次结肠镜检查结果为结肠直肠癌,结果为阴性,再进行结肠镜检查的时间间隔较长
Qunfeng Liang1,2, Trasias Mukama1,3, Kristina Sundquist4,5,6
1Division of Preventive Oncology, National Center for Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany.
JAMA oncology
|May 2, 2024
概括
将结肠直肠癌 (CRC) 查间隔延长到阴性结肠镜检查后的15年,对于没有家族病史的人来说是安全的. 这种变化可以防止每1000人中1个CRC死亡,同时避免1000次结肠镜检查.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 预防医学 预防医学
背景情况:
- 目前的指导方针建议每10年进行一次结肠镜检查,以对平均风险人群进行结肠直肠癌 (CRC) 查.
- 关于最佳查间隔以及安全地延长其可能性存在争论.
研究的目的:
- 评估延长结肠镜查间隔超过10年的安全性和有效性,对于在第一次结肠镜检查中发现负面结果的个人.
主要方法:
- 一项全国性的瑞典队列研究分析了从45-69岁的个人获得的数据,这些人在1990-2016年期间进行了第一次结肠镜检查,结果是负面的.
- 建立了匹配的对照组,并在长达29年的随访期间比较了CRC诊断和CRC特异性死亡率.
主要成果:
- 与对照人群相比,首次结肠镜检查呈阴性结果的个体在长达15年的时间内,CRC和CRC特异性死亡风险显著降低.
- 将间隔延长到15年与10年标准化发病率为0.72和标准化死亡率为0.55相关.
- 将间隔延长到15年,可以错过2例CRC病例,并防止每1000个人中1例CRC死亡,同时避免1000次结肠镜检查.
结论:
- 对于没有家族史CRC和初步负面发现的个人,10年结肠镜查间隔可以安全地延长到15年.
- 较长的查间隔可以减少不必要的侵入性手术的数量.
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