Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study.
Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study.
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DOI：
10.1136/gutjnl-2016-312712
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发表时间：
2018-03
期刊：
影响因子：
24.5
通讯作者：
Fletcher RH
中科院分区：
文献类型：
--
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
筛查结肠镜检查在降低社区人群结直肠癌死亡率风险方面的有效性尚不清楚，特别是对于右半结肠癌，导致在一些国家建议不将其用于筛查。这项研究旨在确定在平均风险人群中，接受筛查性结肠镜检查是否可以降低死于右半结肠癌和左结肠癌/直肠癌的风险。我们在筛选合格的Kaiser Permanente成员中进行了一项发病率-密度匹配的巢式病例对照研究。将2006-2012年期间结直肠癌死亡日期为55-90岁的患者在诊断（参考）日期与年龄、性别、健康计划入组持续时间和地理区域的控制进行匹配。我们排除了结直肠癌风险增加的患者，或先前诊断为结直肠癌或结肠切除术的患者。在考虑其他筛查暴露的同时，评估了参考日期前10年内接受筛查性结肠镜检查与结直肠癌死亡风险之间的关系。我们分析了1747例死于结直肠癌的患者和3460例无结直肠癌的对照组。与未进行内镜筛查相比，接受筛查性结肠镜检查与任何结直肠癌死亡风险降低67%相关（调整后OR（aOR）=0.33，95%CI 0.21 - 0.52）。根据癌症部位，筛查结肠镜检查与右半结肠癌死亡风险降低65%（aOR=0.35，CI 0.18至0.65）和左结肠/直肠癌死亡风险降低75%（aOR=0.25，CI 0.12至0.53）相关。在一个大的社区人群中，筛查性结肠镜检查与右侧和左侧癌症的死亡风险显著降低相关。
Screening colonoscopy's effectiveness in reducing colorectal cancer mortality risk in community populations is unclear, particularly for right-colon cancers, leading to recommendations against its use for screening in some countries. This study aimed to determine whether, among average-risk people, receipt of screening colonoscopy reduces the risk of dying from both right-colon and left-colon/rectal cancers. We conducted a nested case–control study with incidence-density matching in screening-eligible Kaiser Permanente members. Patients who were 55–90 years old on their colorectal cancer death date during 2006–2012 were matched on diagnosis (reference) date to controls on age, sex, health plan enrolment duration and geographical region. We excluded patients at increased colorectal cancer risk, or with prior colorectal cancer diagnosis or colectomy. The association between screening colonoscopy receipt in the 10-year period before the reference date and colorectal cancer death risk was evaluated while accounting for other screening exposures. We analysed 1747 patients who died from colorectal cancer and 3460 colorectal cancer-free controls. Compared with no endoscopic screening, receipt of a screening colonoscopy was associated with a 67% reduction in the risk of death from any colorectal cancer (adjusted OR (aOR)=0.33, 95% CI 0.21 to 0.52). By cancer location, screening colonoscopy was associated with a 65% reduction in risk of death for right-colon cancers (aOR=0.35, CI 0.18 to 0.65) and a 75% reduction for left-colon/rectal cancers (aOR=0.25, CI 0.12 to 0.53). Screening colonoscopy was associated with a substantial and comparably decreased mortality risk for both right-sided and left-sided cancers within a large community-based population.
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影响因子：
9.3
作者：
Kaminski MF;Bretthauer M;Zauber AG;Kuipers EJ;Adami HO;van Ballegooijen M;Regula J;van Leerdam M;Stefansson T;Påhlman L;Dekker E;Hernán MA;Garborg K;Hoff G
通讯作者：
Hoff G
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：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
45.3
作者：
Baxter, Nancy N.;Warren, Joan L.;Doria-Rose, V. Paul
通讯作者：
Doria-Rose, V. Paul
影响因子：
7.7
作者：
Lieberman, David;Nadel, Marion;Winawer, Sidney
通讯作者：
Winawer, Sidney