The Topography of Colorectal Cancer Varies by Race/Ethnicity and Affects the Utility of Flexible Sigmoidoscopy
The Topography of Colorectal Cancer Varies by Race/Ethnicity and Affects the Utility of Flexible Sigmoidoscopy
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结直肠癌的形态因种族/民族而异，并影响柔性乙状结肠镜检查的实用性
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
H. Anton
中科院分区：
文献类型：
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作者：
C. Theuer;T. Taylor;W. Brewster;B. S. Campbell;Juan C. Becerra;H. Anton
结肠直肠癌筛查从50岁开始，建议所有被认为具有结肠直肠癌发展“平均”风险的美国人进行柔性乙状结肠镜检查和粪便潜血试验（FOBT）或结肠镜检查。选择软式乙状结肠镜和FOBT的患者只有在检测到左侧肿瘤或FOBT阳性时才接受全结肠镜检查。不幸的是，在黑人和白人中，大多数右侧结直肠病变不伴有左侧前哨病变，这导致一些人更喜欢对这些患者进行结肠镜筛查。亚洲人和拉丁美洲人的结直肠癌的地形图不可用。我们使用1988-1995年加州癌症登记处的数据来确定105，906例亚洲、黑人、拉丁美洲人和白色患者的连续结直肠癌的地形图。我们发现脾曲远端结直肠癌的比例因种族而异：亚洲人（71%）>拉丁美洲人（63%）>白色人（57%）>黑人（55%）; P < 0.001。在调整年龄和性别后，这些差异是显著的。相对于白人，亚洲人的远端疾病风险为1.61，拉丁裔为1.15，黑人为0.82（P < 0.001）。软性乙状结肠镜检查在亚洲人和拉丁美洲人中检出结直肠癌的比例高于白人或黑人。良性结直肠肿瘤的形态是否与恶性肿瘤相似，还需要进一步研究。结直肠癌筛查建议可能需要纳入结直肠肿瘤地形图的种族和民族差异。
Colorectal cancer screening beginning at age 50 is recommended for all Americans considered at “average” risk for the development of colorectal cancer either with flexible sigmoidoscopy and fecal occult blood testing (FOBT) or with colonoscopy. Patients who elect flexible sigmoidoscopy and FOBT undergo full colonoscopy only if left-sided neoplasia is detected or if the FOBT is positive. Unfortunately in blacks and whites most right-sided colorectal lesions are unaccompanied by left-sided sentinel lesions, which leads some to prefer colonoscopic screening in these patients. The topography of colorectal cancer in Asians and Latinos is unavailable. We used 1988–1995 California Cancer Registry data to determine the topography of 105,906 consecutive colorectal cancers among Asian, black, Latino, and white patients. We found that the proportion of colorectal cancer distal to the splenic flexure and therefore detectable by flexible sigmoidoscopy varied by ethnicity: Asian (71%) > Latino (63%) > white (57%) > black (55%); P < 0.001. These differences were significant after adjusting for age and sex. The risk of distal disease relative to whites was 1.61 in Asians, 1.15 in Latinos, and 0.82 in blacks (P < 0.001). Flexible sigmoidoscopy detects a higher proportion of colorectal cancers in Asians and Latinos than in whites or blacks. Further study is needed to assess whether the topography of benign colorectal neoplasia parallels that of malignant disease. Colorectal screening recommendations may need to incorporate racial and ethnic differences in colorectal neoplasia topography.
影响因子：
158.5
作者：
WINAWER, SJ;ZAUBER, AG;STEWART, ET
通讯作者：
STEWART, ET
影响因子：
158.5
作者：
Imperiale, TF;Wagner, DR;Ransohoff, DF
通讯作者：
Ransohoff, DF