内镜查对上胃肠癌死亡率的影响:一个社区多中心集群随机临床试验
Changfa Xia1, He Li2, Yongjie Xu1
1Office of Cancer Screening, National Cancer Centre/National Clinical Research Centre for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Gastroenterology
|December 20, 2024
概括
内镜查显著减少了中国高风险地区上部胃肠道癌症死亡人数. 在非高风险地区,查没有显示出显著的死亡率益处,需要进一步研究.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 观察性研究表明,内镜查降低了上部胃肠道癌症的死亡率.
- 量化内镜查的影响对于公共卫生战略至关重要.
研究的目的:
- 评估内镜查在减少上部胃肠道癌症死亡率方面的有效性.
- 评估查对中国高风险和非高风险人群的影响.
主要方法:
- 一个基于社区的多中心集群随机临床试验,涉及234,635名参与者.
- 干预:邀请进行内镜查,而不是通常的护理 (未经查).
- 主要结局:由上部胃肠道癌症导致的累积死亡风险,随访至2022年.
主要成果:
- 在高风险地区,内镜查降低了癌症死亡率 (0.77%对0.99%,RR 0.78).
- 在非高风险地区,查没有显示出明显的死亡率降低 (0.26%vs0.30%,RR 0.86).
- 参与者的平均年龄为52岁,随访时间为7.5年.
结论:
- 在高风险的中国人群中,内镜查邀请有效降低了上部胃肠道癌症的死亡率.
- 基于非高风险地区的风险分数的查没有显著降低死亡率;需要更长的随访.
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