在便免疫化学测试基础查计划中的间隔结肠直肠癌.
Wen-Feng Hsu1, Uri Ladabaum2, Chiu-Wen Su1
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
JAMA network open
|July 28, 2025
概括
间隔结肠直肠癌 (CRC) 在结肠镜检查后比在便免疫化学测试 (FIT) 后更常见. 在结肠镜检查期间较高的腺瘤检测率 (ADR) 与更差的存活率相关,这表明当前查方法的潜在局限性.
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:
- 间隔结肠直肠癌 (CRC) 在检查测试或结肠镜检查结果呈阴性后进行诊断.
- 了解与不同查途径相关的风险对于优化CRC预防策略至关重要.
研究的目的:
- 在台湾的查计划中,比较了便免疫化学测试 (FIT后间隔CRC) 与结肠镜 (结肠镜后间隔CRC) 后间隔CRC的发生率,死亡率和存活率.
主要方法:
- 一项队列研究分析了台湾CRC查计划 (2004-2012) 中50-74岁的参与者.
- 确定了两个队列:负FIT结果和负FIT结果与负结肠镜检查.
- 与台湾癌症登记和死亡登记 (2019年之前) 的数据链接被用于确定间隔CRC和生存结果.
- 根据医院级腺瘤检测率 (ADR) 分层分析.
主要成果:
- 间隔CRC发病率和死亡率在结肠镜检查后明显高于阴性FIT检查后.
- 结肠镜后的间隔CRC发病率为0.75/1000人年,而FIT后的0.09/1000人年.
- 较高的医院级ADR与更低的结肠镜后间隔CRC发病率和死亡率有关,但矛盾的是,在这个子组内,更高的CRC特定死亡率.
- 调整后的危险比率表明,结肠镜后与FIT后间隔CRC相比,结肠镜后的发病率高7倍,死亡率高5倍.
结论:
- 接受结肠镜检查的FIT阳性患者患CRC的风险要大得多.
- 在结肠镜检查期间较高的ADR可能表明更彻底的检查,但与间隔CRC的生存率较差有关,这表明当前结肠镜监测的局限性.
- 需要进一步的研究来探索影响CRC结果的程序因素和生物学方面之间的相互作用.
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