Ahmad Muinuddin, Ramona Aslahi, Wilma M Hopman, William G Paterson
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引用次数: 7
Abstract
Background: In 2007, Ontario launched a colon cancer screening program for average-risk individuals based on biennial fecal occult blood tests (FOBTs) on three fecal samples, followed by colonoscopy for individuals who tested positive.
Objective: To determine whether >1 positive screening FOBT was predictive of finding advanced neoplasia at colonoscopy.
Methods: A retrospective chart review of outpatient colonoscopic procedures performed at Hotel Dieu Hospital (Kingston, Ontario) in the first two years of the colon cancer screening program was conducted, focusing on endoscopic and pathological findings.
Results: Of 5556 individuals undergoing colonoscopy, 346 were referred for positive FOBT. Overall, 41 (11.8%) patients with a positive FOBT had colon cancer. In 16 (4.6%) cases, the number of positive FOBTs was not reported. For the 330 individuals in whom the number of positive tests was specified, 198, 71 and 61 cases had one, two and three positive results, respectively. Cancer was found at colonoscopy in 11 (5.6%), 11 (15.5%) and 18 (29.5%) of individuals with one, two and three positive FOBT results, respectively (OR 3.0 [95% CI 1.2 to 7.3] and 6.5 [95% CI 2.8 to 15.0] for two or three positive FOBTs compared with one; P=0.015 and P<0.001, respectively). High-risk adenomas (>1 cm in diameter, villous component and⁄or high-grade dysplasia) were found in 41 (20.8%), 29 (42.0%) and 25 (41.0%) individuals with one, two and three positive FOBTs, respectively (OR 2.8 [95% CI 1.5 to 5.0] and 2.4 [95% CI 1.3 to 4.5] for two or three positive FOBTs compared with one; P=0.001 and P=0.006, respectively).
Conclusions: The diagnostic yield of colonoscopy varied directly with the number of positive FOBTs. This information may be useful in assigning scheduling priority for patients with positive FOBTs.
背景:2007年，安大略省启动了一项针对平均风险个体的结肠癌筛查计划，该计划基于对三个粪便样本进行两年一次的粪便隐血检查(FOBTs)，随后对检测结果阳性的个体进行结肠镜检查。目的:探讨>1阳性FOBT筛查是否预示结肠镜检查发现晚期肿瘤。方法:回顾性回顾在Hotel Dieu医院(Kingston, Ontario)进行结肠癌筛查计划的头两年的门诊结肠镜检查，重点是内镜和病理结果。结果:5556例接受结肠镜检查的患者中，346例为FOBT阳性。总体而言，41例(11.8%)FOBT阳性患者患有结肠癌。在16例(4.6%)病例中，未报告FOBTs阳性数量。在指定阳性检测人数的330人中，分别有198人、71人和61人出现一次、两次和三次阳性结果。在1例、2例和3例FOBT阳性的个体中，结肠镜检查发现癌症的分别为11例(5.6%)、11例(15.5%)和18例(29.5%)(2例或3例FOBT阳性与1例相比，OR为3.0 [95% CI 1.2至7.3]和6.5 [95% CI 2.8至15.0];在41(20.8%)、29(42.0%)和25(41.0%)分别有1、2和3个阳性FOBTs的个体中发现了直径P1 cm、绒毛成分和/或高度发育不良(or为2.8 [95% CI 1.5 ~ 5.0]和2.4 [95% CI 1.3 ~ 4.5]);P=0.001和P=0.006)。结论:结肠镜检查的诊断率与FOBTs阳性的数量直接相关。这一信息可能有助于为FOBTs阳性患者分配调度优先级。
期刊介绍：
Canadian Journal of Gastroenterology and Hepatology is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of gastroenterology and liver disease - medicine and surgery.
The Canadian Journal of Gastroenterology and Hepatology is sponsored by the Canadian Association of Gastroenterology and the Canadian Association for the Study of the Liver.
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