结肠直肠癌发生率和死亡率在结肠镜查结果呈阴性后
Markus Dines Knudsen1,2, Kai Wang1, Liang Wang1,3
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
JAMA oncology
|November 27, 2024
概括
延长结肠镜检查再查间隔超过10年可能对查结果为阴性的人来说是安全的,特别是那些风险较低的人. 这种方法通过考虑结直肠癌的个体风险因素来支持个性化患者护理.
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:
- 目前在阴性结肠镜查 (NCS) 后的10年再查间隔受到质疑.
- 一些研究表明,在NCS之后,结直肠癌 (CRC) 的风险持续降低.
研究的目的:
- 为了研究NCS后的长期CRC发病率和死亡率.
- 根据人口统计和生活方式因素的得分来评估风险.
主要方法:
- 从1988年至1991年至2020年对3个潜在的美国基于人口的队列 (护士健康研究,NHS II,卫生专业人员随访研究) 的分析.
- 考克斯比例危险回归用于计算CRC发病率和死亡率的危险比率 (HR).
- 使用NHANES数据,将风险配置分布与美国普通人口进行比较.
主要成果:
- 在长达20年的时间里,阴性结肠镜查与显著较低的CRC发病率 (HR,0.51) 和死亡率 (HR,0.56) 相关.
- 低风险个人 (分数0-5) 在查后25年才达到10年CRC发病率值.
- 中级风险个体 (得分6-7) 在16岁时达到10年发病率值.
结论:
- 结果支持共享决策,可能在NCS之后将重新选间隔延长到10年之外.
- 个性化查建议应考虑个体CRC风险因素.
- 延长间隔可能对低风险个体特别有益.
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