随机临床试验中的非癌症相关死亡率:元分析
Jiayao Lei1,2,3, Yunyang Deng1, Mark Clements1
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
JAMA network open
|August 25, 2025
概括
癌症查并没有显著增加非癌症死亡. 单独评估目标和非目标死亡率对于完全了解查影响至关重要.
科学领域:
- 癌症学
- 公共卫生
- 生物统计学
背景情况:
- 癌症查对于降低癌症死亡率至关重要,
- 仅仅通过所有原因的死亡率来评估查的影响是不够的,因为它对益处和危害不敏感.
- 了解非癌症相关 (非目标) 死亡率对于全面评估癌症查至关重要.
研究的目的:
- 评估癌症查与非目标死亡率之间的关联.
- 使用随机临床试验 (RCT) 对查和未查个体之间的死亡率进行比较.
主要方法:
- 对现有的癌症查RCT进行系统审查和元分析.
- 包括有关全因和向癌症死亡率的RCT.
- 通过固定效应模型使用速率比率 (RR) 和95%置信区间 (CI) 分析非目标死亡率.
主要成果:
- 分析了17个涉及超过130万参与者的RCT.
- 癌症查没有显著增加非目标死亡率 (RR,1. 00;95% CI,1. 00-1. 01).
- 非目标死亡率的总体增加是微小的 (0. 2%),没有发现显著的异质性.
结论:
- 癌症查与非癌症相关死亡率的大幅增加无关.
- 这些发现强调了独立分析目标和非目标死亡率的重要性.
- 仅仅依靠全因死亡率可以掩盖癌症查干预措施的真正影响.
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