Prevalence of advanced neoplasia at screening colonoscopy in men in private practice versus academic and Veterans Affairs medical centers.
Prevalence of advanced neoplasia at screening colonoscopy in men in private practice versus academic and Veterans Affairs medical centers.
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私人诊所与学术和退伍军人事务医疗中心的男性筛查结肠镜检查时晚期肿瘤的患病率。
DOI：
10.1111/j.1572-0241.2003.07677.x
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Lieberman,DavidA
中科院分区：
文献类型：
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作者：
Harewood,GavinC;Lieberman,DavidA
结论：几项评估平均风险筛查结肠镜检查产率的大型人群研究评估了退伍军人事务部（VA）人群。目前还不确定这些发现对一般人群中的男性有多大的普遍性。本研究的目的是确定在不同的实践settings.METHODS：临床结果研究倡议（科里）的国家内镜数据库进行了分析，以比较男性在社区，学术和VA endoscopysettings.RESULTS：在1998年1月至2002年5月期间，共有9109名男性在社区（5625），学术（2269）和VA（1215）设置进行筛查结肠镜检查的平均风险筛查结肠镜检查的结果。平均风险结肠镜检查的结肠病变（肿块或息肉> 9 mm）的总体发生率为5.1%;每个站点分别为5.7%（社区），3.4%（学术）和5.9%（VA）。在发现病变的患者中，与社区（12.0%）或VA（8.9%）站点相比，学术环境（6.4%）中多发性病变> 9 mm较不常见。在多变量分析中调整年龄和种族时，VA站点的结肠病变检测与社区设置相似。然而，病变识别更有可能在这两个设置（VA：OR= 1.72;社区：OR= 1.56）相比，学术centers.CONCLUSIONS：在接受筛查结肠镜检查的男性中，与VA和社区实践站点相比，学术站点中的息肉> 9 mm的种族和种族调整患病率显著降低。在将男性患者研究的结果从学术中心推广到整个人群时必须谨慎。
OBJECTIVES:Several large population studies assessing the yield of average risk screening colonoscopy have evaluated Veterans Affairs (VA) populations. It remains uncertain how generalizable these findings are to men in the general population. The aim of this study was to define the prevalence of advanced neoplasia in male patients undergoing screening colonoscopy in diverse practice settings.METHODS:The Clinical Outcomes Research Initiative (CORI) national endoscopic database was analyzed to compare the findings in men undergoing average risk screening colonoscopy in community, academic, and VA endoscopy settings.RESULTS:Between January, 1998, and May, 2002, a total of 9109 men underwent screening colonoscopy in community (5625), academic (2269), and VA (1215) settings. Overall yield of colonic lesions (mass or polyp> 9 mm) on average risk colonoscopy was 5.1%; 5.7%(community), 3.4%(academic), and 5.9%(VA) in each site, respectively. Among patients with lesions identified, multiple lesions> 9 mm were less common in academic settings (6.4%) compared to community (12.0%) or VA (8.9%) sites. When adjusting for age and ethnicity on multivariate analysis, colonic lesion detection at VA sites was similar to community settings. However, lesion identification was more likely in both settings (VA: OR= 1.72; community: OR= 1.56) compared to academic centers.CONCLUSIONS:Age-and race-adjusted prevalence of polyps> 9 mm in men who receive screening colonoscopy was significantly lower in academic sites compared to VA and community practice sites. One must be cautious in generalizing the findings of male patient studies from academic centers to the entire population.