低质量,高质量和无查结肠镜后13年结肠直肠癌风险:一个队列研究
Sarina Schwarz1, Malte Braitmaier2, Christian Pox3
1Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Journal of clinical epidemiology
|October 24, 2024
概括
即使是质量较差的结肠镜检查也可以显著降低结肠直肠癌 (CRC) 的风险,而不是没有查. 然而,更高质量的结肠镜可以提供更好的保护,防止CRC的发生.
科学领域:
- 胃肠病学 胃肠病学
- 预防医学 预防医学
- 流行病学 流行病学
背景情况:
- 低质量的结肠镜检查在减少结肠直肠癌 (CRC) 发病率方面,效果不如高质量的结肠镜检查.
- 较低质量的结肠镜与无查结肠镜 (noSC) 对降低CRC风险的比较有效性尚未得到充分证实.
研究的目的:
- 为了比较那些接受了更高质量的查结肠镜检查 (higherQualSC),更低质量的查结肠镜检查 (lowerQualSC) 或没有SC的个体中发展CRC的13年风险.
主要方法:
- 来自德国的医疗保健数据库被用来模拟一个有三个臂的目标试验:higherQualSC,lowerQualSC和noSC.
- 结肠镜检查的质量取决于医生检测的息肉率 (切断值:21.8%).
- 该研究包括55-69岁的平均CRC风险的个体,这些个体在基线时对CRC查无知,随访期为13年.
主要成果:
- 该研究包括142,960在较高的QualSC手臂,62,338在较低的QualSC手臂,和124,040在noSC手臂.
- 经调整后的13年CRC发病率为高QualSC的1.77%,低QualSC的2.09%,无SC的2.74%.
- 与noSC相比,较低的QualSC显示CRC风险降低了24% (RR:0.76),而较高的QualSC显示CRC风险降低了35% (RR:0.65).
结论:
- 与没有查相比,低质量的查结肠镜在减少CRC发病率方面是有效的.
- 较高质量的查结肠镜显示,CRC发病率的减少明显大于质量较差的查结肠镜.
- 低质量的结肠镜在预防CRC中的有效性很大,尽管低于更高质量的程序.
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