Sisse Helle Njor, Mette Bach Larsen, Bo Søborg, Berit Andersen
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引用次数: 3
Abstract
Objective: Evidence of reduction in colorectal cancer (CRC) mortality following CRC screening based on the faecal immunochemical test (FIT) is insufficient. This study aimed to analyse if CRC mortality was reduced after implementing FIT-based screening.
Setting: The Danish national CRC screening programme.
Methods: This nationwide cohort study included residents aged 50-71 years invited to the prevalence round of the screening programme. Invitation order was decided by randomising on birth month; the first two birth months to be invited were classified as invited and the five last were classified as not-yet-invited and given a pseudo invitation data. Follow-up was from (pseudo)invitation date until 31 December 2017, emigration or death. Relative risk (RR) of CRC death was calculated with 95% confidence intervals (CIs).
Results: A total of 897,812 residents were included (29% invited and 71% not-yet-invited). The median follow-up was 3.3 years. The RR of CRC death at end of follow-up was 0.83 (95% CI 0.66; 1.03) among those invited to screening compared with those not yet invited. For men aged 60-71 years, this RR was 0.68 (95% CI 0.49; 0.94). For those participating in screening compared with a similar group of not-yet-invited residents, the RR was 0.71 (95% CI 0.46-1.08). For male participants aged 60-71 years, this RR was 0.49 (95% CI 0.27-0.89). For women and men aged 50-59 years, RRs were small and statistically non-significant.
Conclusion: This nationwide study showed that even within a median follow-up of only 3.3 years, implementing FIT-based CRC screening reduced CRC mortality among older men.
目的:基于粪便免疫化学试验(FIT)的结直肠癌筛查降低结直肠癌死亡率的证据不足。本研究旨在分析实施fit筛查后CRC死亡率是否降低。背景:丹麦国家CRC筛查项目。方法:这项全国性队列研究包括50-71岁的居民，他们被邀请参加筛查项目的患病率轮。邀请顺序由出生月份随机决定;被邀请的前两个出生月被归类为受邀，最后五个出生月被归类为未受邀，并给出一个伪邀请数据。随访从(伪)邀请日起至2017年12月31日，移民或死亡。以95%置信区间(ci)计算结直肠癌死亡的相对危险度(RR)。结果:共纳入居民897,812人(受邀29%，未受邀71%)。中位随访时间为3.3年。随访结束时CRC死亡的RR为0.83 (95% CI 0.66;1.03)，与未获邀请者比较。对于60-71岁的男性，RR为0.68 (95% CI 0.49;0.94)。与未被邀请的居民相比，参加筛查的人的RR为0.71 (95% CI 0.46-1.08)。对于60-71岁的男性参与者，RR为0.49 (95% CI 0.27-0.89)。对于年龄在50-59岁的女性和男性，rr较小且无统计学意义。结论:这项全国性的研究表明，即使在中位随访仅3.3年的情况下，实施基于fit的CRC筛查降低了老年男性的CRC死亡率。
期刊介绍：
Journal of Medical Screening, a fully peer reviewed journal, is concerned with all aspects of medical screening, particularly the publication of research that advances screening theory and practice. The journal aims to increase awareness of the principles of screening (quantitative and statistical aspects), screening techniques and procedures and methodologies from all specialties. An essential subscription for physicians, clinicians and academics with an interest in screening, epidemiology and public health.
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