Index colonoscopy-related risk factors for postcolonoscopy colorectal cancers.
Index colonoscopy-related risk factors for postcolonoscopy colorectal cancers.
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DOI：
10.1016/j.gie.2018.08.023
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发表时间：
2019-01
影响因子：
7.7
通讯作者：
Corley DA
中科院分区：
文献类型：
--
作者：
Tollivoro TA;Jensen CD;Marks AR;Zhao WK;Schottinger JE;Quinn VP;Ghai NR;Zauber AG;Doubeni CA;Levin TR;Fireman B;Quesenberry CP;Corley DA
结肠镜检查后结直肠癌 (PCCRC) 是指结肠镜检查结果呈癌症阴性后 10 年内检测到的癌症，但在大型社区人群中尚未确定可改变的危险因素。我们使用病例对照设计评估了首次结肠镜检查后 1-10 年诊断出的 PCCRC 的危险因素。针对潜在的混杂因素调整了比值比 (OR) 和 95% 置信区间 (CI)。 ≥10 mm 近端息肉（OR 8.18；95%CI 4.59，14.60）； ≥10 mm 远端息肉（OR 3.30；95% CI 1.65，6.58）；腺瘤有（OR 3.23；95% CI 1.83，5.68）和无晚期组织学（OR 1.87；95% CI 1.37，2.55）；不完整的结肠镜检查（OR 5.52；95% CI 2.98，10.21）与 PCCRC 相关。在病例中，早期癌症与晚期癌症（检查后12-36个月与>36个月-10年）的危险因素包括随后癌症的结肠段息肉切除不完全（OR 4.76；95% CI 2.35，9.65）；未能检查节段（OR 2.42；95% CI 1.27，4.60）；节段内息肉≥10 mm（OR 2.38；95% CI 1.53，3.70）。 1206 名 PCCRC 患者中共有 559 名 (46.4%) 具有 1 种或多种对 PCCRC 显着的危险因素（检查不完整、大息肉或任何腺瘤）。在一项全面捕获 PCCRC 的大型社区研究中，几乎一半的 PCCRC 具有与息肉监测或切除以及检查完整性相关的潜在可改变因素。这些代表了进一步提高结直肠癌筛查有效性的潜在高产目标。
Post-colonoscopy colorectal cancers (PCCRCs) are those detected ≤10 years after an index colonoscopy negative for cancer, but modifiable risk factors are not well established in large, community-based populations. We evaluated risk factors from the index colonoscopy for PCCRCs diagnosed 1–10 years after an index colonoscopy using a case-control design. Odds ratios (OR) and 95% confidence intervals (CI) were adjusted for potential confounders. A ≥10 mm proximal polyp (OR 8.18; 95%CI 4.59, 14.60); ≥10 mm distal polyp (OR 3.30; 95% CI 1.65, 6.58); adenoma with (OR 3.23; 95% CI 1.83, 5.68) and without advanced histology (OR 1.87; 95% CI 1.37, 2.55); and an incomplete colonoscopy (OR 5.52; 95% CI 2.98, 10.21) were associated with PCCRC. Among cases, risk factors for early vs. late cancers (12–36 months vs. >36 months-10 years post-examination) included incomplete polyp excision in the colonic segment of the subsequent cancer (OR 4.76; 95% CI 2.35, 9.65); failure to examine the segment (OR 2.42; 95% CI 1.27, 4.60); and a ≥10 mm polyp in the segment (OR 2.38; 95% CI 1.53, 3.70). A total of 559 of 1206 PCCRC patients (46.4%) had 1 or more risk factors that were significant for PCCRC (incomplete examination, large polyp, or any adenoma). In a large community-based study with comprehensive capture of PCCRCs, almost half of PCCRCs had potentially modifiable factors related to polyp surveillance or removal and exam completeness. These represent potential high-yield targets for further increasing the effectiveness of colorectal cancer screening.
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DOI：
10.1056/nejmoa1301969
发表时间：
2013-09-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Nishihara R;Wu K;Lochhead P;Morikawa T;Liao X;Qian ZR;Inamura K;Kim SA;Kuchiba A;Yamauchi M;Imamura Y;Willett WC;Rosner BA;Fuchs CS;Giovannucci E;Ogino S;Chan AT
通讯作者：
Chan AT
影响因子：
24.5
作者：
Doubeni CA;Corley DA;Quinn VP;Jensen CD;Zauber AG;Goodman M;Johnson JR;Mehta SJ;Becerra TA;Zhao WK;Schottinger J;Doria-Rose VP;Levin TR;Weiss NS;Fletcher RH
通讯作者：
Fletcher RH
DOI：
10.1016/j.giec.2006.01.005
发表时间：
2006-01-01
影响因子：
--
作者：
Chutkan, Robynne
通讯作者：
Chutkan, Robynne
影响因子：
6.2
作者：
Cooper GS;Xu F;Barnholtz Sloan JS;Schluchter MD;Koroukian SM
通讯作者：
Koroukian SM
影响因子：
7.7
作者：
Haseman, JH;Lemmel, GT;Rex, DK
通讯作者：
Rex, DK