Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence
Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence
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DOI：
10.1136/gut.48.6.812
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发表时间：
2001-06-01
期刊：
影响因子：
24.5
通讯作者：
Crespi, M
中科院分区：
文献类型：
--
作者：
Citarda, F;Tomaselli, G;Crespi, M
结直肠癌是西方国家癌症死亡的主要原因之一。切除腺瘤是基于这样的假设，即它可能导致结直肠癌的发病率降低，正如美国国家息肉研究所证明的那样。一个关键问题是，在临床试验中观察到的获益是否也可以在标准临床实践中观察到。为了解决这个问题，一个多中心的意大利合作研究organized. Methods的研究队列包括1693名男女，年龄40-69岁，1980年和1987年之间的总结肠检查（TCE）（即，总结肠镜检查或结肠镜检查和双重对比钡灌肠），切除至少一个腺瘤直径大于5毫米。排除标准为遗传综合征、既往腺瘤或结直肠癌、既往结肠切除术、炎症性肠病或直径大于3 cm的无蒂腺瘤。随访于1996年12月通过TCE或电话访谈结束，并审查病历、临床文件或死亡证明。将结直肠癌的发病率与意大利一般人群的预期年龄和性别特异性发病率进行比较。结果-获得了97.3%病例的随访数据，共14211人/年。平均随访10.5年。确定了6例处于不同阶段的结直肠癌病例（4例男性，2例女性）（1例发生在29个月时，2例发生在5年时，1例发生在7年时，1例发生在8年时，1例发生在10年时）。在参考人群中预期的癌症数量为17.7，发病率为0.34（置信区间0.23-0.63; p
Background-Colorectal cancer is one of the leading causes of death from cancer in Western countries. Removal of adenomas is based on the assumption that it could lead to a reduction in the incidence of colorectal cancer, as demonstrated by the National Polyp Study in the USA. A critical issue is whether the benefit observed in clinical trials can also be observed in standard clinical practice. To address the issue, a multicentre Italian collaborative study was organised.Methods-The study cohort comprised 1693 subjects of both sexes, aged 40-69 years, enrolled between 1980 and 1987 following a total colon examination (TCE) (that is, total colonoscopy or colonoscopy and double contrast barium enema), with removal of at least one adenoma larger than 5 mm in diameter. Exclusion criteria were genetic syndromes, previous adenomas or colorectal cancer, previous colonic resection, inflammatory bowel disease, or sessile adenomas more than 3 cm in diameter. Follow up ended in December 1996 by TCE or telephone interview, and review of the medical records, clinical files, or death certificates. Incidence ratios for colorectal cancer were compared with expected age and sex specific incidences in the Italian general population. Results-Follow up data were obtained for 97.3% of cases for a total of 14 211 person/ years. Mean follow up was 10.5 years. Six colorectal cancer cases (four in males, two in females) at various stages were ascertained, (one at 29 months, two at five years, one at seven years, one at eight years, and one at 10 years from the index examination). The number of cancers expected in the reference population was 17.7 for an incidence ratio of 0.34 (confidence interval 0.23-0.63; p