在基于便免疫化学测试的结直肠癌查计划中产生的间隔癌的风险因素和临床后果
Adam D Gerrard1,2, Roberta Garau1,2, Yasuko Maeda1,3
1Cancer Research UK Scotland Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.
BJS open
|October 8, 2025
概括
结肠直肠癌查可以错过癌症,称为间隔癌症. 降低便免疫化学测试值可以更早地检测出更多的癌症,改善生存率.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
背景情况:
- 结肠直肠癌 (CRC) 查旨在检测早期癌症并提高生存率.
- 在定期查测试之间诊断的间隔癌症对查计划的有效性构成挑战.
- 了解间隔CRC的特征和风险因素对于优化查策略至关重要.
研究的目的:
- 为了确定两年随访期间间隔结直肠癌 (CRC) 的比例.
- 调查与间隔CRCs相关的临床结果,包括诊断阶段和存活率.
- 确定有助于间隔CRCs发展的风险因素.
主要方法:
- 利用了来自苏格兰肠道查计划 (2017年11月-2021年10月) 的数据.
- 包括接受便免疫化学测试 (FIT) 的参与者,其阳性结果的值为80μg/g.
- 交叉引用癌症注册表以确保完全捕获所有CRC,包括间隔病例,并分析FIT结果,临床变量和生存数据.
主要成果:
- 在查后2年内,共诊断出257个间隔CRC.
- 与屏幕检测CRC相比,间隔CRC与呈现时更高的晚期发病率和更糟糕的2年全因死亡率相关 (23.0%对10.8%).
- 几乎一半 (47.1%) 的间隔CRC在FIT上具有可检测的血红蛋白水平 (10-79μg/g),这表明早期检测的可能性.
结论:
- 可检测到的FIT结果低于当前值的间隔CRC与较差的结果有关.
- 降低FIT阳性值可能会在更早的阶段识别更多的间隔CRC.
- 通过考虑较低的FIT值来优化查协议,可以改善CRC查计划中的患者存活率.
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