结肠镜作为第一次查测试仍然是有意义的吗?-对照
Mark Pi-Chun Chuang1, Han-Mo Chiu2
1Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan.
Digestive diseases and sciences
|December 6, 2024
概括
便免疫化学测试 (FIT) 为结肠直肠癌 (CRC) 查提供了结肠镜检查的非侵入性,经济有效的替代方案. 基于FIT的两步查提高了参与度,并使个性化风险分层成为更好的CRC预防.
科学领域:
- 胃肠病学 胃肠病学
- 预防医学 预防医学
- 在瘤学瘤学.
背景情况:
- 结肠镜是结肠直肠癌 (CRC) 查的黄金标准,但由于侵入性,成本和低参与度而面临限制.
- 非侵入性查测试,如便免疫化学测试 (FIT) 和便DNA测试正在成为改善人口水平查的替代方案.
- 在提高查参与度方面,FIT已经显示出一致的优势,从而改善了长期的CRC预防结果.
研究的目的:
- 评估基于FIT的两步查的有效性,作为预防CRC的实用和灵活的结肠镜替代方案.
- 突出FIT在加强查参与,使风险分层化和优化结肠镜资源分配方面的作用.
- 倡导将FIT纳入未来的CRC查范式,考虑到有限的内镜容量和早期CRC发病率的上升等因素.
主要方法:
- 对基于FIT的两步查与预防CRC的结肠镜相比的证据的审查.
- 分析FIT的定量性质,可调节的灵敏度值和连续测试能力.
- 评估FIT对参与率,早期癌症检测和晚期腺瘤识别的影响.
主要成果:
- 基于FIT的查显示,参与率始终高于结肠镜检查.
- FIT促进了风险分层,允许更有针对性的使用结肠镜资源.
- 连续FIT测试增加了累积检测率,并改善了早期癌症和晚期腺瘤的识别.
结论:
- 基于FIT的两步查是一种成本效益高,非侵入性和灵活的CRC预防方法.
- FIT显著提高了查参与率,有助于更好的长期CRC预防结果.
- 为风险分层,个性化CRC预防策略,建议将FIT扩展到查范式中.
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