Analysis of colorectal cancer occurrence during surveillance colonoscopy in the dietary Polyp Prevention Trial
Analysis of colorectal cancer occurrence during surveillance colonoscopy in the dietary Polyp Prevention Trial
复制标题
DOI：
10.1016/s0016-5107(04)02765-8
复制
发表时间：
2005-03-01
影响因子：
7.7
通讯作者：
Schatzkin, A
中科院分区：
文献类型：
--
作者：
Pabby, A;Schoen, RE;Schatzkin, A
背景：间歇性结直肠癌（CRC）偶尔在最近接受结肠镜检查的患者中发现。结肠镜检查后发现的CRC系统评价可以确定如何提高质量和colonoscopy.Methods的结果：本研究探讨了癌症诊断的饮食息肉预防试验的过程中，一项随机研究的饮食干预腺瘤性息肉复发。开发了一种算法，将每种癌症分类为4种病因之一：（1）不完全清除（先前腺瘤部位的癌症），（2）活检检测失败（活检标本阴性的疑似瘤形成区域中的癌症），（3）遗漏的癌症（结肠镜检查后短时间内发现的大的晚期癌症），或（4）新癌症结果：在2079例患者中，有13例在5810人年观察（PYO）期间检测到癌症。（2.2例/1000 PYO）; 7/13或53.8%的患者具有潜在的“可避免的”癌症或由于不完全切除（4/13）或遗漏癌症（3/13）而在较早的时间间隔可检测到的癌症。结肠镜检查质量的提高可能降低了癌症的患病率，或导致饮食息肉预防试验中超过50%的流行癌症的早期癌症检测。
Background: Interval colorectal cancer (CRC) occasionally is detected in patients who have recently undergone colonoscopy. Systematic evaluation of CRC detected after colonoscopy could identify ways to improve the quality and the outcome of colonoscopy.Methods: This study examined cancer diagnoses in the course of the dietary Polyp Prevention Trial, a randomized study of a dietary intervention on recurrence of adenomatous polyps. An algorithm was developed to classify each cancer into one of 4 etiologies: (1) incomplete removal (cancer at the site of previous adenoma), (2) failed biopsy detection (cancer in an area of suspected neoplasia with negative biopsy specimens), (3) missed cancer (large, advanced stage cancer found at a short interval after colonoscopy), or (4) new cancer (small, early stage cancer after a longer time interval).Results: Of 2079 patients, 13 had cancer detected over 5810 person years of observation (PYO) (2.2 cases/1000 PYO); 7/13 or 53.8% of patients had either a potentially "avoidable" cancer or one detectable at an earlier time interval because of incomplete removal (4/13) or missed cancer (3/13).Conclusions: Interval cancer occurs despite colonoscopy. Improved quality of colonoscopy may have reduced cancer prevalence or resulted in earlier cancer detection in over 50% of prevalent cancers in the dietary Polyp Prevention Trial.