结肠镜与便隐性血液检测与没有查:对长期影响的比较分析
Deutsches Arzteblatt international
|November 25, 2025
概括
德国结肠直肠癌 (CRC) 查提供便免疫化学测试 (FIT) 或结肠镜检查 (CS),这两种方法都能显著减少CRC病例和死亡. 将CS与FIT结合起来,可以更好地保护CRC死亡率.
科学领域:
- 在瘤学瘤学.
- 预防医学 预防医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结肠直肠癌 (CRC) 是癌症死亡的主要原因,通过查有很大的预防潜力.
- 德国于2025年4月更新了CRC查计划,为50岁以上的个人提供了新的选择.
- 更新后的程序允许选择两年一次的便免疫化学测试 (FIT) 或最多两次隔10年间隔的查结肠镜检查 (CS).
研究的目的:
- 在德国背景下,比较基于FIT的查,基于结肠镜的查和综合方法的长期有效性.
- 评估这些策略对CRC发病率和死亡率的影响.
- 提供有关CRC查选项的信息决策的数据.
主要方法:
- 利用COSIMO,一个经过验证的结直肠癌多阶段模拟模型.
- 模拟10万名50-85岁的男女队伍,假设他们完全遵守查协议.
- 计算和比较FIT,CS和没有查情景的累计CRC病例和CRC相关死亡.
主要成果:
- 在完全遵守FIT和CS查策略的情况下,FIT和CS查策略都显示了CRC病例 (69%的FIT,77%的CS) 和CRC相关死亡 (82%的两者) 的大幅减少.
- 初始结肠镜检查和随后的FIT查的综合策略显示了更大的降低:81%的CRC病例和89%的死亡.
- 发现FIT和CS选策略的有效性在减少CRC负担方面是相似的.
结论:
- 目前在德国提供的结肠直肠癌查策略 (FIT和CS) 的效率很高,其影响力可比较.
- 结合结肠镜和FIT的综合查方法提供了针对CRC死亡率的增强保护.
- 该研究提供了有价值的见解,以支持参与德国CRC查计划的个人做出明智的选择.
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