Colorectal cancer (CRC) screening using sigmoidoscopy followed by colonoscopy:: a feasibility and efficacy study on a cancer institute based population
Colorectal cancer (CRC) screening using sigmoidoscopy followed by colonoscopy:: a feasibility and efficacy study on a cancer institute based population
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DOI：
10.1093/annonc/mdl101
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发表时间：
2006-08-01
影响因子：
50.5
通讯作者：
Grivegnee, A.
中科院分区：
文献类型：
--
作者：
Bleiberg, H.;Autier, P.;Grivegnee, A.
背景资料：乙状结肠镜检查发现的晚期远端肿瘤可能是更近端lessones.Patients和方法的标记：在设置的筛选诊所，受试者进行了灵活的乙状结肠镜检查。如果没有发现明显的病变，则计划在5年后进行乙状结肠镜检查。如果发现晚期肿瘤，则在第一次乙状结肠镜检查后以及第1、3和5年进行结肠镜检查。如果发现非晚期肿瘤，则在1年、3年和5年时进行乙状结肠镜检查，如果发现晚期病变，则进行结肠镜检查。在第一次筛选时，1704/1912（88%）例受试者乙状结肠镜检查阴性，104（5.4%）有晚期瘤形成，96（6%）有非晚期瘤形成，8（0.4%）有浸润性结直肠癌（CRC）。在1年、3年和5年的随访检查中，在170例晚期和非晚期瘤形成受试者中，1例发生浸润性CRC，47例（31.6%）发生晚期瘤形成。5年时，在718例首次阴性乙状结肠镜检查中，572例（80%）被证实为阴性，97例（14%）有晚期肿瘤。在97%的受试者中，可以检查5年时的结直肠癌状态是否为间歇性癌症，并且在5年时未接受乙状结肠镜检查的受试者中未诊断出CRC。将浸润性CRC的发病率与荷兰和卢森堡登记处的数据进行比较，表明CRC的发病率降低了36%-46%。九个CRC中的七个是杜克的A，另外两个是杜克的B和C。结论：在阳性乙状结肠镜检查的情况下进行乙状结肠镜检查筛查导致CRC的发病率大幅下降。发现的大多数CRC都处于其发展的早期、可治愈阶段。
Background: Advanced distal neoplasia found at sigmoidoscopy could be the marker for more proximal lesions.Patients and methods: In the setting of a screening clinic, subjects underwent flexible sigmoidoscopy. If no significant lesion was found, sigmoidoscopy was planned after 5 years. If an advanced neoplasia was found, colonoscopy was performed just after the first sigmoidoscopy and at 1, 3 and 5 years. If a non-advanced neoplasia was found, sigmoidoscopy was performed at 1, 3 and 5 years and followed by colonoscopy if advanced lesion was found.Results: At first screening 1704/1912 (88%) subjects had a negative sigmoidoscopy, 104 (5.4%) had an advanced neoplasia, 96 (6%) had a non-advanced neoplasia and eight (0.4%) had invasive colorectal cancer (CRC). At follow-up examinations at 1, 3 and 5 years, among 170 subjects with advanced and non-advanced neoplasia, one developed invasive CRC and 47 (31.6%), advanced neoplasia. At 5 years, among 718 first negative sigmoidoscopies, 572 (80%) were confirmed negative and 97 (14%) had advanced neoplasia. Colorectal cancer status at 5 years could be checked for interval cancers in 97% of subjects and no CRC was diagnosed in subjects who did not attend sigmoidoscopy at 5 years. Comparison of the incidence of invasive CRC to the data of registries of the Netherlands and Luxembourg suggested that the incidence of CRC was decreased by 36%-46%. Seven of the nine CRCs were Duke's A and the two others were Duke's B and C.Conclusions: Screening with sigmoidoscopy followed by colonoscopy in case of positive sigmoidoscopy leads to substantial decreases in the incidence of CRC. Most CRCs found are at an early, curable stage of their development.