在英格兰的内镜提供者之间,内镜后上部胃肠道癌症发病率的变化和相关因素:基于人口的研究
Umair Kamran1, Felicity Evison2, Eva Judith Ann Morris3
1Department of Gastroenterology, Sandwell and West Birmingham NHS Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland.
在内镜检查后,上部胃肠道癌症 (PEUGIC) 的发病率在提供者之间有很大的差异,这表明内镜检查质量存在差异. 提高检测率可以导致更早的诊断和更好的患者对上部胃肠道癌症的结果.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 后内镜上部胃肠道癌症 (PEUGIC) 作为内镜质量的关键指标.
- 在英格兰的内镜提供者之间存在PEUGIC费率的显著差异.
研究的目的:
- 为了检查英格兰不同内镜供应商PEUGIC费率的变化.
- 确定与PEUGIC利率相关的因素,以了解潜在的原因.
主要方法:
- 一项以人口为基础的,回顾性病例控制研究,利用来自国家癌症注册和分析服务和医院病例统计数据的数据.
- 在2009年至2018年期间在英国诊断的食道和胃癌的分析.
- 用多变量逻辑回归来确定相关因素.
主要成果:
- 国家PEUGIC费率为8.5%,个人提供者费率在5%至13%之间.
- 与较高的PEUGIC率相关的因素包括女性性别,年龄较小,并发病率增加,特定的先前存在的疾病 (,巴雷特食道),状细胞癌和缺乏国家认证.
结论:
- PEUGIC率的三倍变化表明内镜质量存在显著的,不合理的差异.
- PEUGIC与已知的胃肠上部癌症风险因素和不充分的提供者认证有关.
- 解决这些变异为增强早期癌症检测和改善患者治疗结果提供了机会.
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