Initial impact of Australia's National Bowel Cancer Screening Program
Initial impact of Australia's National Bowel Cancer Screening Program
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DOI：
10.5694/j.1326-5377.2009.tb02843.x
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发表时间：
2009-10-05
影响因子：
11.4
通讯作者：
Gibbs, Peter
中科院分区：
文献类型：
--
作者：
Ananda, Sumitra S.;McLaughlin, Stephen J.;Gibbs, Peter
目的：为了研究国家肠癌筛查计划（NBCSP）的初步影响，该计划于2006年5月启动，为55岁或65岁的澳大利亚人提供粪便潜血检测。设计和设置：回顾2006年5月至2008年6月期间诊断的结直肠癌（CRC）病例数据，这些病例来自19家澳大利亚医院的前瞻性数据库，主要结果指标：通过NBCSP或症状表现检测到的CRC病例数，以及性别、诊断时的分期、肿瘤位置和社会经济弱势水平的差异。结果：确定了1628例CRC; 1268例患者的检测状态信息作为NBCSP的一部分，其中40例（3.2%）被记录为被NBCSR检测到。在75例年龄在55岁或65岁的CRC患者中，22例被NBCSP检测到。总的来说，NBCSP-受保护的病例在性别上没有差异。NBCSP检测的病例和有症状的病例之间肿瘤位置的分布相似，但NBCSP检测的癌症比有症状的癌症诊断更早（1期，40%对14%; IV期，3%对15%）。通过NBCSP诊断的患者中，63%来自社会经济条件最差的地区（十分位数8-10），18%来自最贫困的地区（十分位数1-4）（P = 0.0375）。结论：澳大利亚NBCSP的启动对诊断时的CRC分期有可衡量的影响，预计生存率会有所改善。来自贫困地区的人的接受率较低令人关切。
Objective: To examine the initial impact of the National Bowel Cancer Screening Program (NBCSP), which was launched in May 2006 and offers faecal occult blood testing to Australians aged 55 or 65 years.Design and setting: Review of data on colorectal cancer (CRC) cases diagnosed between May 2006 and June 2008 from a prospective database used at 19 Australian hospitals, linked and analysed by BioGrid Australia.Main outcome measures: Number of CRC cases detected through the NBCSP or symptomatic presentation, and differences by sex, stage at diagnosis, tumour location and level of socioeconomic disadvantage.Results: 1628 cases of CRC were identified; 1268 had information on the patients' test status as part of the NBCSP, and 40 of these (3.2%) were recorded as being detected by the NBCSR. Of 75 CRC cases in patients aged 55 or 65 at diagnosis, 22 were NBCSP-detected. Overall, there was no difference in NBCSP-cletected cases by sex. The distribution of tumour locations was similar between NBCSP-detected cases and symptomatic cases, but NBCSP-detected cancers were diagnosed at an earlier stage than symptomatic cancers (stage 1, 40% v 14%; stage IV, 3% v 15%, respectively). Of patients diagnosed through the NBCSP, 63% were from areas of least socioeconomic disadvantage (deciles 8-10) and 18% were from the most disadvantaged areas (deciles 1-4) (P = 0.0375).Conclusion: Initiation of the Australian NBCSP has had a measurable impact on CRC stage at diagnosis, and an improvement in survival would be anticipated. The lower uptake among people from disadvantaged areas is of concern.