Time to Colonoscopy After Abnormal Stool-Based Screening and Risk for Colorectal Cancer Incidence and Mortality.
Time to Colonoscopy After Abnormal Stool-Based Screening and Risk for Colorectal Cancer Incidence and Mortality.
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DOI：
10.1053/j.gastro.2021.01.219
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发表时间：
2021-05
期刊：
影响因子：
29.4
通讯作者：
May FP
中科院分区：
文献类型：
--
作者：
San Miguel Y;Demb J;Martinez ME;Gupta S;May FP
在基于粪便的结直肠癌（CRC）筛查试验异常后完成诊断性结肠镜检查的最佳时间间隔尚不确定。我们研究了在异常粪便筛查后接受诊断性结肠镜检查的个体中，结肠镜检查时间与结直肠癌结局之间的关系。我们对1999年至2010年期间粪便潜血试验（FOBT）或粪便免疫化学试验（FIT）异常的50-75岁退伍军人进行了回顾性队列研究。我们使用多变量考克斯比例风险来生成CRC特异性发病率和死亡率风险比（HR）以及3个月结肠镜检查间隔的95%置信区间（CI），其中1-3个月作为参考组。结肠镜检查时间与晚期CRC诊断的相关性也进行了研究。我们的队列包括204，733例患者。平均年龄为61岁（SD：6.9）。与在1-3个月时接受结肠镜检查的患者相比，在1 - 3 -15个月（HR=1.13，95%CI：1.00-1.27）、16-18个月（HR=1.25，95%CI：1.10-1.43）、19-21个月（HR=1.28，95%CI：1.11-1.48）和22-24个月（HR =1.26，95%CI：1.07-1.47）时接受结肠镜检查的患者的CRC风险增加。与在1-3个月时接受结肠镜检查的患者相比，在19-21个月（HR=1.52，95%CI：1.51-1.99）和22-44个月（HR=1.39，95%CI：1.03-1.88）时接受结肠镜检查的患者死亡风险更高。晚期CRC的几率在16个月时增加。结肠镜检查时间延长与FIT/FOBT异常后结直肠癌发病率、死亡和晚期结直肠癌风险升高相关。改善CRC结局的干预措施应强调FIT/FOBT结果异常后1年内的诊断随访。结肠镜检查时间增加与结直肠癌（CRC）诊断、CRC相关死亡和FIT/FOBT异常后晚期CRC的风险增加相关。
The optimal time interval for diagnostic colonoscopy completion after an abnormal stool-based colorectal cancer (CRC) screening test is uncertain. We examined the association between time to colonoscopy and CRC outcomes among individuals who underwent diagnostic colonoscopy after abnormal stool-based screening. We performed a retrospective cohort study of Veterans age 50–75 years with an abnormal fecal occult blood test (FOBT) or fecal immunochemical test (FIT) between 1999 and 2010. We used multivariable Cox proportional hazards to generate CRC-specific incidence and mortality hazard ratios (HRs) and 95% confidence intervals (CI) for 3-month colonoscopy intervals, with 1–3 months as the reference group. Association of time to colonoscopy with late-stage CRC diagnosis was also examined. Our cohort included 204,733 patients. Mean age was 61 years (SD: 6.9). Compared to patients who received a colonoscopy at 1–3 months, there was an increased CRC risk for patients who received a colonoscopy at: 13–15 months (HR=1.13, 95%CI:1.00–1.27), 16–18 months (HR=1.25, 95%CI:1.10–1.43), 19–21 months (HR=1.28, 95%CI:1.11–1.48), and 22–24 months (HR=1.26, 95%CI:1.07–1.47). Compared to patients who received a colonoscopy at 1–3 months, mortality risk was higher in groups who received a colonoscopy at: 19–21 months (HR=1.52, 95%CI:1.51–1.99) and 22–44 (HR=1.39, 95%CI:1.03–1.88). Odds for late stage CRC increased at 16 months. Increased time to colonoscopy is associated with higher risk of CRC incidence, death, and late stage CRC after abnormal FIT/FOBT. Interventions to improve CRC outcomes should emphasize diagnostic follow-up within 1 year of an abnormal FIT/FOBT result. Increased time to colonoscopy is associated with higher risk of colorectal cancer (CRC) diagnosis, CRC-related death, and advanced stage CRC after abnormal FIT/FOBT.
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DOI：
10.1158/1055-9965.epi-15-0470
发表时间：
2016-02
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Chubak J;Garcia MP;Burnett-Hartman AN;Zheng Y;Corley DA;Halm EA;Singal AG;Klabunde CN;Doubeni CA;Kamineni A;Levin TR;Schottinger JE;Green BB;Quinn VP;Rutter CM;PROSPR consortium
通讯作者：
PROSPR consortium
DOI：
10.3322/caac.21452
发表时间：
2018-05
期刊：
CA: a cancer journal for clinicians
影响因子：
--
作者：
Doubeni CA;Gabler NB;Wheeler CM;McCarthy AM;Castle PE;Halm EA;Schnall MD;Skinner CS;Tosteson ANA;Weaver DL;Vachani A;Mehta SJ;Rendle KA;Fedewa SA;Corley DA;Armstrong K
通讯作者：
Armstrong K
影响因子：
24.5
作者：
Libby, Gillian;Fraser, Callum G.;Steele, Robert J. C.
通讯作者：
Steele, Robert J. C.
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
12.6
作者：
May, Folasade P.;Yano, Elizabeth M.;Washington, Donna L.
通讯作者：
Washington, Donna L.