结直肠癌筛查——最近的NordICC试验对美国人群意味着什么?

IF 3 4区 医学 Q1 Medicine
Taranika Sarkar Das, Jessica Rauch, Aasma Shaukat
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引用次数: 0

摘要

结肠直肠癌(CRC)的发病率随着时间的推移而下降,尽管它仍然是美国发病率和死亡率的重要原因。在所有癌症中,它的发病率排名第三,是男性和女性癌症死亡的第二大原因。筛查可降低结直肠癌的发病率和死亡率。CRC筛查有几种方式,但最常见的是在非侵入性粪便检测(如粪便免疫化学检测(FIT))或侵入性内窥镜检查(如结肠镜检查)之间进行选择。在美国,结肠镜检查是主要的CRC筛查方式,观察性研究报告CRC发病率和死亡率大幅降低。最近,一项关于结肠镜检查有效性的大型随机对照试验(RCT)报告,结肠镜筛查对CRC发病率的降低小于预期,并且没有降低CRC死亡率。对低于预期收益的解释包括结肠镜检查使用率低,对一些参与结肠镜筛查的内窥镜医师的死亡率终点和质量指标(QIs)随访时间短。这项研究的结果需要与其他关于结肠镜检查有效性的文献结合起来考虑,其总体信息是让患者确信筛查和结肠镜检查的好处。在这里,我们讨论结肠镜筛查的最新证据及其在其他筛查方式和景观的背景下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Colorectal cancer screening—what does the recent NordICC trial mean for the U.S. population?
: The incidence of colorectal cancer (CRC) has declined over time, though it remains a significant cause of morbidity and mortality in the U.S. It has the third highest incidence in incidence among all cancers and is the second leading cause of cancer death in both men and women. Screening reduces the incidence and mortality from CRC. There are several modalities for CRC screening, but the most common ones are a choice between a non-invasive stool-based test, such as fecal immunochemical testing (FIT) or an invasive endoscopic modality, such as colonoscopy. In the U.S. colonoscopy is the predominant CRC screening modality, with observational studies reporting large reductions in CRC incidence and mortality. Recently, a large randomized controlled trial (RCT) on effectiveness of colonoscopy reported smaller than expected reduction in CRC incidence and no reduction in CRC mortality with colonoscopy screening. Explanations of the lower than expected benefit include low uptake of colonoscopy, short follow-up for mortality endpoints and quality indicators (QIs) for some of the endoscopists participating in the screening colonoscopies. The findings of the study need to be taken in context with other literature on effectiveness of colonoscopy, with the overall message of reassuring patients of the benefits of screening, and colonoscopy. Here, we discuss the latest evidence on colonoscopy screening and it in the context of other screening modalities and the landscape.
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来源期刊
CiteScore
8.20
自引率
0.00%
发文量
1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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