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重新评估人口层面的查建议,以应对澳大利亚日益增加的早期结直肠癌率:一项建模研究
J-B Lew1, J Worthington1, H Ge1
1The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, Australia.
ESMO gastrointestinal oncology
|February 6, 2026
概括
将肠癌查的开始年龄降至45岁可以显著降低死亡率,并且具有成本效益. 这一变化支持早期检测结直肠癌的最新指南.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 癌症查 癌症查
背景情况:
- 国家肠癌查计划 (NBCSP) 目前每两年对50-74岁的澳大利亚人进行一次免疫化学便隐性血液测试 (iFOBTs).
- 在50岁以下的人群中,早期结直肠癌 (CRC) 的发病率越来越高,需要对当前的查策略和指导方针进行评估.
- 该研究旨在评估替代查年龄范围和方法,以优化澳大利亚的CRC预防.
研究的目的:
- 评估修改NBCSP查年龄参数对结直肠癌死亡率的影响.
- 为了确定不同查场景的成本效益和利益与危害的平衡.
- 根据建模数据,为澳大利亚CRC查指南的更新提供信息.
主要方法:
- 使用微模拟模型来模拟各种查策略.
- 场景包括在40岁,45岁或50岁开始查,并在74岁,79岁或84岁停止,每两年进行一次iFOBT测试.
- 额外的分析考虑了年度iFOBT查和每两年一次的便生物标志物测试.
主要成果:
- 在45岁或40岁开始查可以使CRC死亡率分别降低5%和10%.
- 将查计划延长到79岁或85岁可以使CRC死亡率分别降低3%和5%.
- 与延长停止年龄相比,降低查开始年龄显示出更高的成本效益和更有利的益处-危害概况.
结论:
- 降低查开始年龄是减轻CRC负担和危害的成本有效策略,特别是随着早期CRC发病率的上升.
- 澳大利亚癌症委员会建议每两年从45岁到74岁进行iFOBT查,这是最佳方法.
- 这些发现影响了2023年的指导方针,并导致NBCSP从2024年7月开始为45-49岁的人提供选择性查.
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