Influence of long-term colonoscopic surveillance on incidence of colorectal cancer and death from the disease in patients with precursors (adenomas)
Influence of long-term colonoscopic surveillance on incidence of colorectal cancer and death from the disease in patients with precursors (adenomas)
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DOI：
10.1080/02841860600897918
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发表时间：
2007-01-01
期刊：
影响因子：
3.1
通讯作者：
Rasmussen, Morten
中科院分区：
文献类型：
--
作者：
Jorgensen, Ole Dan;Kronborg, Ole;Rasmussen, Morten
病例对照研究和短期前瞻性研究表明，选定的结直肠癌前体患者组可能会受益于腺瘤初次切除后的结肠镜监测。本研究的目的是证明长期（1-24年）结肠镜监测对所有类型腺瘤患者（无论大小和切除方式如何）的可能益处。1978年至2002年，2041例首次诊断为结直肠腺瘤的患者被纳入前瞻性监测。所有腺瘤均被考虑。使用年龄、性别和随访的日历特定人年数计算CRC的发病率和CRC死亡率，以与标准丹麦人群进行比较。27例患者发现CRC，预期人数为41例（RR 0.65，95%CI 0.43-0.95）。27例患者中有3例死于CRC，预期人数为25例（RR 0.12，95% CI 0.03-0.36）。共6289次结肠镜检查，20例患者发生严重并发症，2例死于并发症。长期结肠镜监测可降低散发性腺瘤患者的CRC发病率和死亡率。由于监测的并发症，这种益处被降低到很小的程度。
Case-control studies and short term prospective studies have suggested that selected groups of patients with precursors of colorectal cancer may benefit from colonoscopic surveillance after initial removal of adenomas. The aim of the present study was to demonstrate such a possible benefit from long term ( 1-24 years) colonoscopic surveillance in a population of patients with all types of adenomas regardless of size and way of removal. Two thousand and forty-one patients with a first time diagnosis of colorectal adenoma were included in prospective surveillance between year 1978 and 2002. All adenomas were considered. Incidence of CRC and mortality from CRC was calculated, using age, sex, and calendar specific number of person years of follow-up for comparison with the standard Danish population. CRC was found in 27 patients, the expected number being 41 ( RR 0.65, 95% CI 0.43-0.95). Three of the 27 patients died from CRC, the expected number being 25 ( RR 0.12, 95% CI 0.03-0.36). A total of 6 289 colonoscopies resulted in severe complications in 20 patients and two died from complications. Long-term colonoscopic surveillance may reduce incidence of CRC as well as mortality in patients with sporadic adenomas. The benefit is reduced to a minor degree by complications from surveillance.