结肠镜和便免疫化学测试与结肠直肠癌诊断查中的常规护理相比:SCREESCO随机对照试验
Marcus Westerberg1, Jonas F Ludvigsson2,3, Chris Metcalfe4
1Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. marcus.westerberg@uu.se.
结肠直肠癌 (CRC) 查与结肠镜检查或便免疫化学测试 (FIT) 增加了早期癌症检测. 然而,查也显示不良事件的轻微增加,特别是在第一年,表明好处和危害.
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:
- 建议对50至75岁的个人进行结肠直肠癌 (CRC) 查.
- 主要查方法包括结肠镜检查和便免疫化学检测 (FIT).
- 该SCREESCO试验旨在量化与常规护理相比,CRC查的益处和危害.
研究的目的:
- 为了比较查 (结肠镜检查,FIT) 和常规护理之间的诊断CRC的发病率.
- 评估查与对照组中胃肠道和心血管事件的发生率.
- 评估CRC查的好处和危害.
主要方法:
- 一项随机对照试验涉及278280名60岁以上的个人.
- 参与者被分配到一次性结肠镜检查,两轮FIT或常规护理.
- 随访时间中位数为4.8年.
主要成果:
- 在结肠镜和对照组 (IRR: 1.08) 和FIT和对照组 (IRR: 0.92) 之间,CRC发病率相似.
- 早期 (I-II) CRC的发病率在结肠镜 (IRR: 1.38) 和FIT (IRR: 1.19) 组中都高于对照组.
- 在干预后的第一年,胃肠道和心血管方面的不良事件略有增加.
结论:
- 通过结肠镜或FIT进行CRC查,通过增加早期结肠直肠癌的检测,证明了益处.
- 观察到的不良事件的增加表明与查干预相关的潜在初始危害.
- 将早期检测的好处与潜在危害相平衡,对于优化CRC查策略至关重要.
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