Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large Community-Based Population.
Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large Community-Based Population.
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DOI：
10.1053/j.gastro.2018.07.017
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发表时间：
2018-11
期刊：
影响因子：
29.4
通讯作者：
Doubeni CA
中科院分区：
文献类型：
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作者：
Levin TR;Corley DA;Jensen CD;Schottinger JE;Quinn VP;Zauber AG;Lee JK;Zhao WK;Udaltsova N;Ghai NR;Lee AT;Quesenberry CP;Fireman BH;Doubeni CA
关于有组织结直肠癌(CRC)筛查在社区人群中筛查摄取率、发病率和死亡率的有效性的信息很少。我们对比了2007年至2008年(主要是年度粪便免疫化学检测和结肠镜检查)在以社区为基础的大量人口中实施有组织的筛查宣传(主要是年度粪便免疫化学检测和结肠镜检查)之前(基准年为2000年)和实施后(至2015年)的筛查率、年龄调整的年度CRC发病率和基于发病率的死亡率。在51-75岁符合筛查条件的个体中，我们计算了每年最新的癌症筛查状况(通过粪便检测、乙状结肠镜检查或结肠镜检查)、CRC发病率、癌症分期分布和基于发病率的死亡率。启动有组织的结直肠癌筛查显著提高了筛查的最新状况，从2000年的38.9%上升到2015年的82.7%(P<；.01)。较高的筛查率与2000年至2015年间结直肠癌年发病率下降25.5%(从95.8例/10万例降至71.4例/10万例)以及癌症死亡率下降52.4%(从30.9例/10万例降至14.7例/10万例(P<；.01)相关。筛查的增加最初与结直肠癌发病率的增加有关，这主要是由于早期癌症的更大发现，随后癌症发病率的下降。晚期结直肠癌发病率下降36.2%，从45.9例/10万下降到29.3例/10万(P<；.01)；早期结直肠癌发病率下降14.5%，从48.2例/10万下降到41.2例/10万(P<；0.04)。在以社区为基础的大量人口中实施有组织的结直肠癌筛查计划，迅速将筛查参与率提高到国家组织设定的≥80%的目标。筛查率是可持续的，与在短时间内大幅降低结直肠癌发病率和死亡率有关，这与早期发现和癌症预防是一致的。
Little information is available on the effectiveness of organized colorectal cancer (CRC) screening on screening uptake, incidence, and mortality in community-based populations. We contrasted screening rates, age-adjusted annual CRC incidence, and incidence-based mortality rates before (baseline year 2000) and after (through 2015) implementation of organized screening outreach, from 2007 through 2008 (primarily annual fecal immunochemical testing and colonoscopy), in a large, community-based population. Among screening-eligible individuals 51–75 years old, we calculated annual up to date status for cancer screening (by fecal test, sigmoidoscopy, or colonoscopy), CRC incidence, cancer stage distributions, and incidence-based mortality. Initiation of organized CRC screening significantly increased the up to date status of screening, from 38.9% in 2000 to 82.7% in 2015 (P<.01). Higher rates of screening were associated with a 25.5% reduction in annual CRC incidence between 2000 and 2015, from 95.8 to 71.4 cases/100,000 (P<.01), and a 52.4% reduction in cancer mortality, from 30.9 to 14.7 deaths/100,000 (P<.01). Increased screening was initially associated with increased CRC incidence, largely due to greater detection of early-stage cancers, followed by decreases in cancer incidence. Advanced-stage CRC incidence rates decreased 36.2%, from 45.9 to 29.3 cases/100,000 (P<.01), and early-stage CRC incidence rates decreased 14.5%, from 48.2 to 41.2 cases/100,000 (P<.04). Implementing an organized CRC screening program in a large, community-based population rapidly increased screening participation to the ≥80% target set by national organizations. Screening rates were sustainable and associated with substantial decreases in CRC incidence and mortality within short time intervals, consistent with early detection and cancer prevention.
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影响因子：
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作者：
Inadomi, John M.;Vijan, Sandeep;Janz, Nancy K.;Fagerlin, Angela;Thomas, Jennifer P.;Lin, Yunghui V.;Munoz, Roxana;Lau, Chim;Somsouk, Ma;El-Nachef, Najwa;Hayward, Rodney A.
通讯作者：
Hayward, Rodney A.
影响因子：
24.5
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
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Fletcher RH
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12.6
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Lakoff, Josh;Paszat, Lawrence F.;Rabeneck, Linda
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Rabeneck, Linda
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7.2
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CHU, KC;MILLER, BA;HANKEY, BF
通讯作者：
HANKEY, BF
影响因子：
10.3
作者：
Allison, James E.;Sakoda, Lori C.;Selby, Joseph V.
通讯作者：
Selby, Joseph V.