从检测到延迟:后科洛的现实世界差距® 结肠镜坚持
Muhammad Ali Ibrahim Kazi1, Imran Qureshi2, Akshay Sharma3
1Anne Arundel Medical Center, Annapolis, MD, USA.
Journal of gastrointestinal cancer
|November 18, 2025
概括
只有44%的Cologuard®测试阳性患者完成了随访结肠镜检查,这表明粘附性很差. 该研究强调需要改善结直肠癌查的患者教育和护理途径.
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) 是癌症死亡的一个重要原因,需要有效的早期检测策略.
- 科洛加德 (Cologuard®) 是一种非侵入性便DNA测试,有助于CRC和癌前病变的检测,但有局限性,包括高错误阳性率和对结肠镜后续检查的要求.
研究的目的:
- 为了评估阳性Cologuard®结果的患者中的结肠镜后续检查率.
- 评估诊断结果,包括癌症和息肉检测,在阳性Cologuard®测试后.
主要方法:
- 使用TriNetX真实世界数据平台进行了一项回顾性队列研究.
- 分析了年龄在18岁或以上,Cologuard®测试呈阳性的患者.
- 主要结局:结肠镜检查在12个月内完成;次要结局:随访结肠镜检查的诊断.
主要成果:
- 在385名获得Cologuard®阳性结果的患者中,只有171名 (44%) 在12个月内接受了随访结肠镜检查.
- 恶性瘤 (结肠直肠癌) 在10名患者 (5.8%) 中被诊断为恶性瘤,良性瘤 (息肉) 在56名患者 (32.7%) 中被诊断为良性瘤.
- 阳性预测值很低,只有38.5%的阳性测试导致显著的病变检测.
结论:
- 在阳性Cologuard®测试后的随访结肠镜粘附性是次优的.
- 由于Cologuard®的高错误阳性率,需要制定改善患者教育和简化护理途径的策略.
- 加强沟通和支持对于改善CRC查后续合规至关重要.
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