Cohort profile: cholangiocarcinoma screening and care program (CASCAP).
Cohort profile: cholangiocarcinoma screening and care program (CASCAP).
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DOI：
10.1186/s12885-015-1475-7
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发表时间：
2015-06-09
期刊：
影响因子：
3.8
通讯作者：
CASCAP investigators
中科院分区：
文献类型：
--
作者：
Khuntikeo N;Chamadol N;Yongvanit P;Loilome W;Namwat N;Sithithaworn P;Andrews RH;Petney TN;Promthet S;Thinkhamrop K;Tawarungruang C;Thinkhamrop B;CASCAP investigators
胆管癌（CCA）是一种极具侵略性的癌症，通常是致命的。尽管全球发病率和死亡率都在上升，但对该病的了解仍然有限。东南亚的湄公河地区，特别是泰国东北部，迄今为止是全球CCA发病率最高的地区，孔敬省报告的CCA发病率为每10万男性135.4例，每10万女性43.0例。大多数患者在疾病晚期首次发现，5年生存率低于10%。从1984年开始，控制和预防战略的重点是健康教育。虽然早期发现可以大大提高5年生存率，但目前还没有提高早期诊断的策略。胆管癌筛查和护理项目（CASCAP）是一项前瞻性队列研究，包括筛查组和患者组两组。对于筛查队列，将至少每年定期进行超声检查，以确定当前是否存在胆管和/或肝脏病理，以便建立早期诊断的最佳筛查方案。这一队列预计将包括至少15万来自CCA高风险地区的个体。对于患者队列，预计在5年的招募期内将纳入约25,000例CCA患者。所有CCA患者都将按照常规临床护理进行治疗并随访，以便制定有效的手术治疗方案。这个队列实际上是一个传统的癌症登记处。因此，CASCAP是一个正在进行的项目，其中参与者的数量是动态变化的。这是第一个在社区一级对高危人群进行筛查的CCA项目。在撰写本报告时，共有85,927人被纳入筛查队列，其中55.0%的人已经接受了超声筛查，2661例CCA病例被纳入患者队列。筛查的参与者平均年龄为53.8±9.8岁，55.6%为女性，77.5%为小学以上文化程度，79.9%为农民，29.9%报告有亲属患有CCA， 89.1%吃过生鱼，42.2%接受肝吸虫检测的人被发现感染。
Cholangiocarcinoma (CCA) is an extremely aggressive cancer that is usually fatal. Although globally morbidity and mortality are increasing, knowledge of the disease remains limited. The Mekong region of Southeast Asia, and particularly the northeast of Thailand, has by far the highest incidence of CCA worldwide with 135.4 per 100,000 among males and 43.0 per 100,000 among females being reported in Khon Kaen Province. Most patients are first seen during late stage disease with 5-year survival being less than 10 %. Starting in 1984, control and prevention strategies have been focused on health education. Although early detection can substantially increase 5-year survival, there are currently no strategies to increase early diagnosis. The Cholangiocarcinoma Screening and Care Program (CASCAP) is a prospective cohort study comprising two cohorts- the screening and the patient cohorts. For the screening cohort, ultrasound examination will be carried out regularly at least annually to determine whether there is current bile duct and/or liver pathology so that the optimal screening program for early diagnosis can be established. This cohort is expected to include at least 150,000 individuals coming from high-risk areas for CCA. For the patient cohort, it is estimated that about 25,000 CCA patients will be included during the 5-year recruitment period. All CCA patients will be treated according to routine clinical care and followed so that effective surgical treatment can be formulated. This cohort is indeed a conventional cancer registry. Thus, CASCAP is an ongoing project in which the number of participants changes dynamically. This is the first project on CCA that involves screening the at risk population at the community level. At the time of preparing this report, a total of 85,927 individuals have been enrolled in the screening cohort, 55.0 % of whom have already undergone ultrasound screening, and 2661 CCA cases have been enrolled in the patient cohort. Among the participants of the screening, whose mean age was 53.8 ± 9.8 years, 55.6 % were female, 77.5 % attained primary school as the highest level of education, 79.9 % were farmers, 29.9 %, reported having relatives with CCA, 89.1 % had eaten uncooked fish, and 42.2 % of those who had been tested for liver fluke were found to be infected.
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