Surveillance after positive and negative colonoscopy examinations: issues, yields, and use.
Surveillance after positive and negative colonoscopy examinations: issues, yields, and use.
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阳性和阴性结肠镜检查后的监测：问题、产量和使用。
DOI：
10.1111/j.1572-0241.2003.07492.x
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Schoen,RobertE
中科院分区：
文献类型：
--
作者：
Schoen,RobertE
随着结直肠癌筛查被公众接受，结肠镜检查的使用将会增加。腺瘤发现后的监测检查频率是结直肠癌筛查成本的最大因素之一。在具有里程碑意义的国家息肉研究发表十年后，何时进行监测检查以及多久一次期待先进发现的问题仍然尖锐。目前的监督指导方针因专业组织而异。晚期腺瘤患者复发的风险更高。多个非进展期腺瘤或单个非进展期腺瘤对随后发生进展期腺瘤或癌症的风险的影响尚不清楚。无论是结肠镜检查还是乙状结肠镜检查，最初的阴性检查后的重复检查结果更是鲜为人知。在确定结肠镜检查的推荐间隔时，阴性检查后的产率是一个重要的考虑因素。例如，支持结肠镜检查间隔10年的数据只是间接的。在阴性检查后，我们对产量所知甚少的信息来自于精选的、没有代表性的群体。令人担忧的是，来自几项息肉预防试验的证据表明，尽管在随访中使用了相对较高的监测程序，但后续癌症的产率高于预期。需要对监督检查的使用频率和成效进行进一步的以人口为基础的研究。检查后续监测的必要性和所需时间的研究对于控制筛查成本以及更好地告知公众内窥镜筛查可以实现什么和不能实现什么是至关重要的。
As colorectal cancer screening gains acceptance by the public, the use of colonoscopy will increase. The frequency of surveillance examinations after detection of an adenoma is one of the largest contributors to the cost of colorectal cancer screening. Ten years after the publication of the landmark National Polyp Study, the issue of when to perform surveillance examinations and how often to expect advanced findings remains acute. Current guidelines for surveillance vary across specialty organizations. Individuals with advanced adenomas are at increased risk for recurrent advanced adenomas. The impact of multiple nonadvanced adenomas or a single nonadvanced adenoma on subsequent risk of an advanced adenoma or cancer is less clear. Still less is known about findings on repeat examinations after an initial negative examination, whether after colonoscopy or sigmoidoscopy. The yield after a negative examination is an important consideration in determining the recommended interval for screening colonoscopy. For example, the data supporting a 10-yr interval for screening colonoscopy is only indirect. What little we do know about the yield after negative examinations comes from selected, nonrepresentative populations. Of concern, evidence from several polyp prevention trials demonstrates higher yields for subsequent cancer than would be expected, despite a relatively high use of surveillance procedures in follow-up. Further population-based research on the frequency of use and yield of surveillance examinations is needed. Studies that examine the need and the needed timing of subsequent surveillance are essential to containing costs for screening as well as to informing the public better about what endoscopic screening can and cannot accomplish.
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首次结肠镜检查时的腺瘤特征作为腺瘤复发和随访特征的预测因子。
影响因子：
29.4
作者：
R. Stolk;G. Beck;J. Baron;R. Haile;R. Summers
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DOI：
--
发表时间：
2007
期刊：
影响因子：
--
作者：
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通讯作者：
Furutani
影响因子：
158.5
作者：
ATKIN, WS;MORSON, BC;CUZICK, J
通讯作者：
CUZICK, J
影响因子：
7.7
作者：
Haseman, JH;Lemmel, GT;Rex, DK
通讯作者：
Rex, DK
基于柔性乙状结肠镜的结直肠癌筛查的潜在成本。
影响因子：
29.4
作者：
Marshall,JR;Fay,D;Lance,P
通讯作者：
Lance,P