将问卷调查作为组织大肠癌筛查的一种分层方法

D. P. Kulovskaya, Y. Shelygin, S. A. Frolov
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引用次数: 0

摘要

研究目的:比较调查问卷和粪便免疫化学检验在结直肠癌筛查中对风险人群进行分层的有效性。作为俄罗斯联邦中央联邦区试点项目的一部分,进行了一项非随机比较研究,以评估两种大肠癌筛查分层方法的有效性。第一组的分层方法是原始问卷,第二组的分层方法是粪便免疫化学检验(FIT)。第一组和第二组的所有参与者都在筛查的第二阶段接受了结肠镜检查。共有 250 名受访者参加了研究,其中 128 人参加了问卷调查组,122 人参加了粪便免疫化学检验(FIT)组。在问卷调查组中,发现 91 人(71.1%)罹患大肠癌的风险较高,37 人(28.9%)罹患大肠癌的风险较低。根据结肠镜检查结果,有 65 人(50.8%)确诊为大肠癌和大肠息肉,63 人(49.2%)未发现明显病变。在 FIT 组中,102 人(83.6%)检测结果呈阳性(FIT+),20 人(16.4%)检测结果呈阴性(FIT-)。根据结肠镜检查结果,75 人(61.5%)被诊断出患有结肠直肠癌和结肠息肉,47 人(38.5%)未发现明显病变。问卷的灵敏度为 86.2 %(95 % CI 75.3-93.5%),特异性为 44.4 %(95 % CI 31.9-57.5%);阳性结果的预测值为 61.5 %(95 % CI 50.7-71.6%),阴性结果的预测值为 75.7 %(95 % CI 58.8-88.2%)。FIT 的灵敏度为 86.7 %(95 % CI 76.8-93.4%),特异性为 21.3 %(95 % CI 10.7-35.7%),阳性结果的预测值为 63.7 %(95 % CI 53.6-73.0%),阴性结果的预测值为 50.0 %(95 % CI 27.2-72.8%)。总之,大肠癌筛查模式中的问卷调查法在灵敏度和特异性方面与 FIT 相当。必须强调的是,问卷调查法不仅易于实施,而且不会产生巨大的经济成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Questionnaire as a stratification method in organizing colorectal cancer screening
The purpose of the study: to compare the efficacy of questionnaires and fecal immunochemical tests in stratification of risk groups during colorectal cancer screening. A non-randomized comparative study was conducted to evaluate the effectiveness of two stratification methods for colorectal cancer screening as part of pilot projects in the regions of the Central Federal District of the Russian Federation. In the first group, the stratification method was the original questionnaire, and in the second group — the fecal immunochemical test (FIT). All participants included in the first and second groups underwent colonoscopy at the second stage of screening. A total of 250 respondents participated in the study, 128 in the questionnaire group and 122 in the FIT group. In the questionnaire group, a high risk of colorectal cancer was found in 91 (71.1 %) individuals, while 37 (28.9 %) respondents had a low risk. Based on colonoscopy results, colorectal cancer and colorectal polyps were diagnosed in 65 (50.8 %) participants, and no significant pathology was found in 63 (49.2 %). In the FIT group, 102 (83.6 %) participants tested positive (FIT+) and 20 (16.4 %) tested negative (FIT-). According to the results of the performed colonoscopy, colorectal cancer and colon polyps were diagnosed in 75 (61.5 %) individuals, while no significant pathology was detected in 47 (38.5 %) participants. The sensitivity of the questionnaire was 86.2 % (95 % CI 75.3–93.5 %) and specificity was 44.4 % (95 % CI 31.9–57.5 %); the predictive value of a positive result was 61.5 % (95 % CI 50.7–71.6 %), and the predictive value of a negative result was 75.7 % (95 % CI 58.8–88.2 %). The FIT sensitivity was 86.7 % (95 % CI 76.8–93.4 %), the specificity was 21.3 % (95 % CI 10.7–35.7 %), the predictive value of a positive result was 63.7 % (95 % CI 53.6–73.0 %), and the predictive value of a negative result was 50.0 % (95 % CI 27.2–72.8 %). In conclusion, the questionnaire method in the colorectal cancer screening model is comparable in sensitivity and specificity to those of the FIT. It is essential to emphasize that questionnaires, along with ease of implementation, do not entail significant economic costs.
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