Characteristics of Missed or Interval Colorectal Cancer and Patient Survival: A Population-Based Study
Characteristics of Missed or Interval Colorectal Cancer and Patient Survival: A Population-Based Study
复制标题
DOI：
10.1053/j.gastro.2014.01.013
复制
发表时间：
2014-04-01
期刊：
影响因子：
29.4
通讯作者：
Burt, Randall W.
中科院分区：
文献类型：
--
作者：
Samadder, N. Jewel;Curtin, Karen;Burt, Randall W.
背景与目的：结肠镜检查后数年内确诊的结直肠癌，可能是由于漏诊或新肿瘤的发展所致。我们调查了结肠镜检查后6-60个月内发生间隔癌的比例、特征和预测因素。方法：我们对1995年至2009年在山间医疗或犹他大学医疗系统接受结肠镜检查的犹他州居民进行了一项基于人群的队列研究，该系统为85%以上的州居民提供护理。结肠镜检查结果与犹他州人口数据库中的癌症病史相关联，以确定在诊断为CRC(间歇性癌症)之前6-60个月接受结肠镜检查的患者。采用Logistic回归分析确定与间歇性癌症相关的危险因素。结果：在126851例接受结肠镜检查的患者中，2659例被诊断为结直肠癌；其中6%(159例)在结肠镜检查后6至60个月内发生。性别和年龄与间期CRCs无关。间歇性结直肠癌患者在结肠镜检查中发现腺瘤的比例(57.2%)高于结肠镜检查发现的结直肠癌患者(36%)或未发生癌症的患者(26%)(P
BACKGROUND & AIMS: Colorectal cancers (CRCs) diagnosed within a few years after an index colonoscopy can arise from missed lesions or the development of a new tumor. We investigated the proportion, characteristics, and factors that predict interval CRCs that develop within 6-60 months of colonoscopy. METHODS: We performed a population-based cohort study of Utah residents who underwent colonoscopy examinations from 1995 through 2009 at Intermountain Healthcare or the University of Utah Health System, which provide care to more than 85% of state residents. Colonoscopy results were linked with cancer histories from the Utah Population Database to identify patients who underwent colonoscopy 6-60 months before a diagnosis of CRC (interval cancer). Logistic regression was performed to identify risk factors associated with interval cancers. RESULTS: Of 126,851 patients who underwent colonoscopies, 2659 were diagnosed with CRC; 6% of these CRCs (159 of 2659) developed within 6 to 60 months of a colonoscopy. Sex and age were not associated with interval CRCs. A higher percentage of patients with interval CRC were found to have adenomas at their index colonoscopy (57.2%), compared with patients found to have CRC detected at colonoscopy (36%) or patients who did not develop cancer (26%) (P