Identifying the need for a UK colorectal cancer screening programme for patients with cystic fibrosis (CF): 10-year retrospective review of colonoscopy and colorectal cancer outcomes at a single CF centre.

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
Karuna Sapru, Peter Barry, Andrew Jones, John Walmsley, Javaid Iqbal, Dipesh H Vasant
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引用次数: 0

Abstract

Objective: Patients with cystic fibrosis (pwCF) have a high incidence of early colorectal cancer (CRC). In the absence of a UK CRC screening programme for pwCF, we evaluated the utility and outcomes of colonoscopy and CRC at a large UK CF centre.

Design: In a retrospective study of colonoscopy and CRC outcomes between 2010 and 2020 in pwCF aged≥30 years at a large CF centre, data were collected on colonoscopy indications and findings, polyp detection rates, bowel preparation regimens and outcomes, colonoscopy completion rates, and patient outcomes.

Results: We identified 361 pwCF aged ≥30 years, of whom 135 were ≥40 years old. In the absence of a UK CRC screening guideline only 33 (9%)/361 pwCF aged ≥30 years (mean age: 44.8±11.0 years) had a colonoscopy between 2010 and 2020. Colonoscopy completion rate was 94.9%, with a 33% polyp detection rate, 93.8% of the polyps retrieved were premalignant. During the study period no patients developed postcolonoscopy CRC. However, of the patients aged ≥40 years who did not have a colonoscopy (111/135, 82.2%), four (3.6%) patients developed CRC and three pwCF died from complications of CRC.

Conclusion: In this 10-year experience from a large CF centre, colonoscopy uptake for symptomatic indications was low, yet of high yield for premalignant lesions in pwCF >40 years. These data highlight the risk of potentially preventable, early CRC, and therefore support the need for prospective, large-scale nationwide studies which may inform the need for UK CRC screening guidelines for pwCF.

Abstract Image

Abstract Image

确定英国对囊性纤维化(CF)患者进行结直肠癌筛查计划的必要性:对单个CF中心结肠镜检查和结直肠癌结果的10年回顾性回顾。
目的:囊性纤维化(pwCF)患者是早期结直肠癌(CRC)的高发患者。在英国没有针对pwCF的CRC筛查项目的情况下,我们在英国一家大型CF中心评估了结肠镜检查和CRC的效用和结果。设计:在一个大型CF中心对2010年至2020年年龄≥30岁的pwCF患者结肠镜检查和结直肠癌结果进行回顾性研究,收集结肠镜检查指征和发现、息肉检出率、肠准备方案和结果、结肠镜检查完成率和患者结果的数据。结果:我们确定了361例年龄≥30岁的pwCF,其中135例年龄≥40岁。在英国没有CRC筛查指南的情况下,2010年至2020年期间,年龄≥30岁(平均年龄:44.8±11.0岁)的pwCF患者中,只有33(9%)/361人接受了结肠镜检查。结肠镜检查完成率为94.9%,息肉检出率为33%,检出息肉癌前病变率为93.8%。在研究期间,没有患者发生结肠镜检查后结直肠癌。然而,在年龄≥40岁且未进行结肠镜检查的患者中(111/135,82.2%),4例(3.6%)患者发生CRC, 3例pwCF患者死于CRC并发症。结论:在这个来自大型CF中心的10年经验中,结肠镜检查对症状适应症的使用率很低,但在>40年的pwCF中,恶性病变的发生率很高。这些数据强调了潜在可预防的早期结直肠癌的风险,因此支持了前瞻性的、大规模的全国性研究的必要性,这可能会为英国的pwCF CRC筛查指南提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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