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便免疫化学测试查和结肠直肠癌的风险死亡

Chyke A Doubeni1,2, Douglas A Corley3, Christopher D Jensen3

  • 1Department of Family and Community Medicine, The Ohio State University College of Medicine, Columbus.

JAMA network open
|July 19, 2024
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概括

便免疫化学检测 (FIT) 查显著降低结直肠癌 (CRC) 死亡率,特别是在左侧瘤. 这种好处跨越了各种种族和民族群体,支持其在公共卫生战略中的使用.

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科学领域:

  • 在瘤学瘤学.
  • 胃肠病学 胃肠病学
  • 公共卫生 公共卫生
  • 预防医学 预防医学

背景情况:

  • 结肠直肠癌 (CRC) 仍然是一个重大的健康问题,查测试如便免疫化学测试 (FIT) 对于早期检测至关重要.
  • 尽管广泛使用,但关于FIT查在减少不同人群和癌症位置的CRC死亡率方面的有效性仍然在不断发展.
  • 了解FIT对CRC特异性死亡率的影响,特别是瘤部位和人口因素的影响,对于优化查计划至关重要.

研究的目的:

  • 评估FIT查与结直肠癌 (CRC) 死亡风险之间的关联.
  • 为了确定FIT查的有效性是否因瘤的位置而异 (例如,左结肠与右结肠).
  • 评估FIT查对不同种族和族群CRC死亡率的影响.

主要方法:

  • 一个嵌套病例控制研究是在两个综合卫生系统的大量可接受查的个人队列中进行的.
  • 病例包括在2011-2017年间死于结直肠腺癌的52-85岁的个体,根据人口统计和健康计划持续时间与对照 (1:8比例) 相匹配.
  • 暴露被定义为在诊断前5年内完成一个或多个FIT查;结果包括CRC死亡,根据瘤位置和种族/种族进行分析.

主要成果:

  • 完成一个或多个FIT查与33%较低的CRC死亡风险相关 (aOR,0.67).
  • 对左侧结肠和直肠癌 (aOR,0.58),但对右侧结肠癌 (aOR,0.83) 没有观察到显着较低的CRC死亡风险.
  • 在非西班牙裔亚洲人 (aOR,0.37),非西班牙裔黑人 (aOR,0.58) 和非西班牙裔白人 (aOR,0.70) 个人中,FIT查表明CRC死亡风险降低.

结论:

  • 查FIT与整体CRC死亡率的风险降低有关,对左结肠和直肠癌观察到的效果更为明显.
  • 针对CRC死亡的FIT查的保护性关联在各种种族和种族群体中是一致的,这突显了其广泛的适用性.
  • 这些发现强烈支持FIT在基于人口的结直肠癌查策略中的整合和持续使用.