Prevention of advanced colorectal cancer by screening using the immunochemical faecal occult blood test: a case-control study
Prevention of advanced colorectal cancer by screening using the immunochemical faecal occult blood test: a case-control study
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DOI：
10.1038/sj.bjc.6601002
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发表时间：
2003-07-07
影响因子：
8.8
通讯作者：
Munakata, A
中科院分区：
文献类型：
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作者：
Nakajima, M;Saito, H;Munakata, A
为了评估粪便潜血检测（FOBT）筛查在预防晚期癌症方面的作用，我们在对所有40岁或以上居民提供免疫化学FOBT年度筛查计划的地区进行了一项病例对照研究。病例为研究区连续357例临床诊断为晚期结直肠癌或肿瘤侵犯固有肌层及更深的患者，即TNM分类中的T-2-T-4。在病例诊断前1年内，根据性别、年龄、居住区域和暴露状况为每例病例选择3名对照进行筛查。采用条件logistic回归分析计算发生晚期癌症的比值比（ORs）。诊断前3年内接受筛查者与未接受筛查者的OR为0.54（95%可信区间（CI） 0.29-0.99）。直肠的or低于结肠（分别为0.32 ~ 0.73和0.84 ~ 1.18）。在过去3年内接受筛查的患者中，发展为晚期直肠癌的OR为0.32 （95% CI: 0.12-0.84）。免疫化学FOBT筛查方案可有效预防晚期结直肠癌。直肠癌的风险降低似乎比结肠癌更大。
To evaluate colorectal cancer screening with faecal occult blood testing (FOBT) in terms of prevention of advanced cancers, we conducted a case-control study in the areas where an annual screening programme with immunochemical FOBT has been offered to all inhabitants aged 40 years or over. Cases were 357 consecutive patients in the study areas clinically diagnosed as having advanced colorectal cancer or a tumour invading the muscularis propriae or deeper, that is, T-2-T-4 in TNM classification. Three controls were selected for each case matched by gender, age, residential area and exposure status to screening within 1 year before case diagnosis. The odds ratios (ORs) of developing advanced cancer were calculated using conditional logistic regression analyses. The OR for those screened within 3 years before the diagnosis vs those not screened was 0.54 (95% confidence interval (CI) 0.29-0.99). The ORs were lower for rectum than for colon (0.32-0.73 and 0.84-1.18 for rectum and colon, respectively). For those screened within the past 3 years, OR of developing advanced cancer in the rectum was 0.32 (95% CI: 0.12-0.84). A screening programme with immunochemical FOBT can be effective for prevention of advanced colorectal cancer. Risk reduction appears to be larger for rectal than for colon cancer.