查结肠镜的影响:来自观察和干预研究的证据
Hermann Brenner1,2, Dmitry Sergeev1,2, Thomas Heisser1
1German Cancer Research Center (DKFZ), Heidelberg, Germany.
查结肠镜显著降低结肠直肠癌 (CRC) 的发病率和死亡率,根据观察和干预研究. 组织良好的查计划具有更高的坚持可以实现类似的人口水平的好处.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 预防医学 预防医学
背景情况:
- 美国国家多胞体研究 (1993年) 确立了结肠镜多胞体检作为预防结肠直肠癌 (CRC) 的关键策略.
- 由于查,CRC发病率和死亡率在老年人群中下降,但在年轻人群中增加.
- 观察性研究始终表明,随着查结肠镜检查,CRC发病率和死亡率降低.
研究的目的:
- 审查观察性和干预性研究中的证据,以评估查结肠镜对预防CRC的有效性.
- 在评估结肠镜检查对CRC的影响的研究中分析设计特征和潜在偏差.
- 为了比较查结肠镜与其他人口水平查策略的疗效.
主要方法:
- 观察性研究的系统审查 (例如,大规模的队列研究).
- 对评估长期CRC发病率和死亡率的随机对照试验的分析.
- 批判性评估研究设计,坚持率和潜在的偏见来源.
主要成果:
- 观察性和干预性研究都提供了强有力的证据,证明查结肠镜的预防作用.
- 研究结果中发现了明显的差异,需要仔细解释.
- 查结肠镜与CRC发病率和死亡率的显著降低有关.
结论:
- 有令人信服的证据支持查结肠镜在预防结肠直肠癌中的作用.
- 高的坚持率和组织良好的查计划对于人口水平的CRC减少至关重要.
- 较少侵入性的查测试,具有较高的坚持率,可以为结肠镜提供与结肠镜相比较的人口水平的好处.
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