Use of colonoscopy as a primary screening test for colorectal cancer in average risk people
Use of colonoscopy as a primary screening test for colorectal cancer in average risk people
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DOI：
10.1016/j.amjgastroenterol.2203.09.041
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发表时间：
2003-12-01
影响因子：
9.8
通讯作者：
Martínez-González, MA
中科院分区：
文献类型：
--
作者：
Betés, M;Muñoz-Navas, MA;Martínez-González, MA
目的：结肠镜检查作为结直肠癌（CRC）的主要筛查试验在平均风险的成年人是一个有争议的主题。我们的主要目标是建立一个预测模型的基础上，一些简单的变量，可以用来作为一个指导，以确定平均风险的成年人更适合结肠镜检查作为一个主要的筛选test.Methods：晚期腺瘤的患病率进行了评估，在2210个连续的成年人至少40岁，没有已知的危险因素CRC的主要筛查结肠镜检查。年龄，性别，临床和生化数据进行了比较之间的人没有腺瘤，那些与非先进的腺瘤，和那些与任何先进的肿瘤。一个综合评分，以评估先进的腺瘤的风险是建立与多元Logistic回归analysis.Results选择的变量：肿瘤病变被发现在617例（27.9%），包括259至少有一个肿瘤是10朗姆酒或更大，绒毛，或中度至重度异型增生，和11例浸润性癌。晚期病变在男性、老年人和体重指数（BMI）较高的人群中更常见。在多变量分析中，这三个变量是晚期腺瘤的独立预测因子。结合年龄，性别和BMI的分数开发作为一个指南，用于识别个人更适合筛查colonoscopy.Conclusions：年龄，性别和BMI可以用来建立一个简单的分数，以选择那些平均风险的成年人谁可能是候选人的初级筛查结肠镜检查。
Objective: The use of colonoscopy as a primary screening test for colorectal cancer (CRC) in average risk adults is a subject of controversy. Our primary objective was to build a predictive model based on a few simple variables that could be used as a guide for identifying average risk adults more suitable for examination with colonoscopy as a primary screening test.Methods: The prevalence of advanced adenomas was assessed by primary screening colonoscopy in 2210 consecutive adults at least 40 yr old, without known risk factors for CRC. Age, gender, and clinical and biochemical data were compared among people without adenomas, those with non-advanced adenomas, and those with any advanced neoplasm. A combined score to assess the risk of advanced adenomas was built with the variables selected by multiple logistic regression analysis.Results: Neoplastic lesions were found in 617 subjects (27.9%), including 259 with at least one neoplasm that was 10 rum or larger, villous, or with moderate-to-severe dysplasia, and 11 with invasive cancers. Advanced lesions were more frequent among men, older people, and those with a higher body mass index (BMI). These three variables were independent predictors of advanced adenomas in multivariate analysis. A score combining age, sex, and BMI was developed as a guide for identifying individuals more suitable for screening colonoscopy.Conclusions: Age, gender, and BMI can be used to build a simple score to select those average risk adults who might be candidates for primary screening colonoscopy.