Surveillance after resection for colorectal cancer
Surveillance after resection for colorectal cancer
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DOI：
10.1002/cncr.27852
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发表时间：
2013-03-15
期刊：
影响因子：
6.2
通讯作者：
Haas, Jennifer S.
中科院分区：
文献类型：
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作者：
Brawarsky, Phyllis;Neville, Bridget A.;Haas, Jennifer S.
背景：专业协会推荐对结直肠癌（CRC）幸存者进行治疗后监测。本研究描述了长期监测的使用情况，特别关注种族/民族差异，并研究了地区特征（如CRC筛查能力）在监测中的作用。方法：监测，流行病学和最终结果(SEER)-医疗保险数据用于识别1993年至2005年诊断为结直肠癌并接受手术治疗的66至85岁的个体。该研究检查了与随后接受结肠镜检查、癌胚抗原（CEA）检测、初级保健（PC）就诊和综合监测相关的因素。结果：在符合条件的受试者中，61.0%进行了结肠镜检查，68.0%进行了CEA检查，77.1%进行了PC检查，43.0%接受了全面监测。调整后，黑人接受结肠镜检查的可能性低于白人（优势比[OR] 0.76, 95%可信区间[CI] = 0.69-0.83），接受CEA检测和总体监测的可能性也低于白人，而白人/西班牙裔的比例没有差异。从1993年到2005年，所有结果的比率都有所增加，但黑人和白人之间的差异仍然存在。在CRC筛查能力最强的地区，个体接受结肠镜检查的可能性更大（OR = 1.09, 95% CI = 1.02-1.18），而在黑人比例最大的地区，个体接受结肠镜检查的可能性更小（OR = 0.89, 95% CI = 0.83-0.95）。生活在缺乏PC的地区的人接受PC访问（OR = 0.55, 95% CI = 0.48-0.64）和总体监测（OR = 0.83, 95% CI = 0.71-0.98）的可能性较小。结论：许多结直肠癌幸存者没有得到推荐的监测，黑人/白人在监测率上的差异并没有改善。个人居住区域的特点有助于使用监控。2013年癌症。(c) 2012年美国癌症协会。
BACKGROUND: Professional societies recommend posttreatment surveillance for colorectal cancer (CRC) survivors. This study describes the use of surveillance over time, with a particular focus on racial/ethnic disparities, and also examines the role of area characteristics, such as capacity for CRC screening, on surveillance. METHODS: Surveillance, Epidemiology, and End Results (SEER)-Medicare data were used to identify individuals aged 66 to 85 years who were diagnosed with CRC from 1993 to 2005 and treated with surgery. The study examined factors associated with subsequent receipt of a colonoscopy, carcinoembryonic antigen (CEA) testing, primary care (PC) visits, and a composite measure of overall surveillance. RESULTS: Of eligible subjects, 61.0% had a colonoscopy, 68.0% had CEA testing, 77.1% had PC visits, and 43.0% received overall surveillance. After adjustment, blacks were less likely than whites to undergo colonoscopy (odds ratio [OR] 0.76, 95% confidence interval [CI] = 0.69-0.83) and to receive CEA testing and overall surveillance, whereas white/Hispanic rates did not differ. Rates for all outcomes increased from 1993 to 2005, but black/white disparities remained. Individuals in areas with greatest capacity for CRC screening were more likely (OR = 1.09, 95% CI = 1.02-1.18) to receive colonoscopy, and those in areas with the greatest percentage of blacks were less likely (OR = 0.89, 95% CI = 0.83-0.95) to receive colonoscopy. Those living in areas with shortage of PC were less likely to receive PC visits (OR = 0.55, 95% CI = 0.48-0.64) and overall surveillance (OR = 0.83, 95% CI = 0.71-0.98). CONCLUSIONS: Many CRC survivors do not get recommended surveillance, and black/white disparities in rates of surveillance have not improved. Characteristics of the area where an individual lives contribute to the use of surveillance. Cancer 2013. (c) 2012 American Cancer Society.