在综合医疗保健系统中,在FIT阳性后,诊断结肠镜的延迟
Gabriel Monti1,2, Ellen Clark3,4, David Lieberman4,5
1Department of Medicine, Oregon Health & Science University, 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA. Gabriel.monti@va.gov.
Digestive diseases and sciences
|January 22, 2025
概括
在阳性便免疫化学测试 (FIT) 后诊断结肠镜的完成率仍然很低,即使在COVID-19大流行期间. 这会影响结肠直肠癌查计划的有效性.
科学领域:
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
- 在瘤学瘤学.
背景情况:
- 结肠直肠癌查依赖于便免疫化学测试 (FIT),然后进行诊断性结肠镜检查以获得阳性结果.
- 在FIT阳性后完成结肠镜检查对于查计划的有效性至关重要.
研究的目的:
- 评估COVID-19大流行对FIT阳性后诊断结肠镜检查完成率的影响.
- 分析大肠镜检查完成的趋势,在大流行时期的早期和晚期之前,在早期和晚期.
主要方法:
- 在5年时间内对FIT阳性患者进行了回顾性研究.
- 将FIT测试分为流行病前,流行病早期和流行病晚期的阶段.
- 主要结果:在FIT阳性后6个月内完成的及时诊断结肠镜的比例.
主要成果:
- 只有50%的患者在阳性FIT后6个月内完成了诊断性结肠镜检查.
- 及时结肠镜检查率从大流行前的56%下降到大流行初期的39%和大流行后的49%.
- 没有进行结肠镜检查的常见原因包括患者衰退,由于并发症而延期临床医生或患者死亡.
结论:
- 在疫情前和期间都观察到FIT阳性后结肠镜完成率较低,这表明查计划有效性存在重大障碍.
- 鉴于高患者死亡率或结肠镜检查的医学禁忌,相当一部分阳性FIT结果可能是不合适的.
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