Colonoscopic miss rates for right-sided colon cancer: A population-based analysis
Colonoscopic miss rates for right-sided colon cancer: A population-based analysis
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DOI：
10.1053/j.gastro.2004.05.032
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发表时间：
2004-08-01
期刊：
影响因子：
29.4
通讯作者：
Rabeneck, L
中科院分区：
文献类型：
--
作者：
Bressler, B;Paszat, LF;Rabeneck, L
背景与目的：结肠镜检查对结直肠癌有固有的漏诊率。尽管先前已经报道了因内镜专业知识而闻名的学术中心或单位的漏诊率，但在常规临床实践中进行的结肠镜检查的结直肠癌漏诊率尚不清楚。我们进行了一项以人群为基础的研究，以估计安大略结肠镜检查期间漏诊的右半结肠癌的比例。研究方法：从1997年4月1日至2001年3月31日，在安大略住院接受手术切除的所有20岁新诊断为右侧结肠癌的患者均被确定。在诊断后3年内进行结肠镜检查的患者被分为2组：检出癌症（诊断前6个月内进行结肠镜检查的患者）和漏诊癌症（诊断前6至36个月内进行结肠镜检查的患者）。数据来自加拿大健康信息研究所出院摘要数据库、安大略健康保险计划数据库和注册人员数据库。结果如下：从1997年4月1日至2001年3月31日，我们确定了4920例新诊断为右半结肠癌的患者，其中2654例（53.9%）在入院手术切除后3年内至少做过1次结肠镜检查。大多数（96.0%）在入院前6个月内进行了最近一次结肠镜检查（发现癌症）。然而，105例患者（4.0%）在入院前6至36个月进行了最近一次结肠镜检查（漏诊癌症）。结论：在因右侧结肠癌接受切除术的患者中，在常规临床实践中结肠镜检查检测癌症的漏诊率为4.0%。
Background & Aims: Colonoscopy contains an inherent miss rate for colorectal cancer. Although miss rates from academic centers or units known for their endoscopic expertise have been previously reported, the colorectal cancer miss rate of colonoscopy performed in usual clinical practice is unknown. We conducted a population-based study to estimate the proportion of right sided colon cancers missed during colonoscopy in Ontario. Methods: All persons 20 years old with a new diagnosis of right-sided colon cancer admitted to the hospital for surgical resection in Ontario from April 1, 1997, to March 31, 2001, were identified. Patients who had a colonoscopy within 3 years of their diagnosis were divided into 2 groups: detected cancers (those who had a colonoscopy up to 6 months before the diagnosis) and missed cancers (those who had a colonoscopy between 6 and 36 months before the diagnosis). Data were obtained from the Canadian Institute for Health Information Discharge Abstract Database, the Ontario Health Insurance Plan database, and the Registered Persons Database. Results: Between April 1, :1997, and March 31, 2001 we identified 4920 persons with a new diagnosis of right-sided colon cancer, of whom 2654 (53.9%) had had at least 1 colonoscopy within 3 years of their admission for surgical resection. Most (96.0%) had had their most recent colonoscopy up to 6 months before admission (detected cancers). However, 105 patients (4.0%) had their most recent colonoscopy between 6 and 36 months before admission to the hospital (missed cancers). Conclusions: Among persons undergoing resection for right-sided colon cancer, the miss rate of colonoscopy for detecting cancer in usual clinical practice was 4.0%.