Association between colonic screening, subject characteristics, and stage of colorectal cancer
Association between colonic screening, subject characteristics, and stage of colorectal cancer
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DOI：
10.1111/j.1572-0241.2005.00319.x
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发表时间：
2005-11-01
影响因子：
9.8
通讯作者：
Gallinger, S
中科院分区：
文献类型：
--
作者：
Fazio, L;Cotterchio, M;Gallinger, S
结直肠癌仍然是北美死亡率和发病率的重要原因。结直肠癌的生存率高度依赖于诊断时的分期，因此确定与分期相关的因素非常重要。本研究评估了受试者因素（例如，方法：根据肿瘤-淋巴结-转移（TNM）分期系统，将1997年至1999年由安大略家族性结肠癌登记处招募的基于人群的结肠直肠癌病例进行分期，并分为早期（TNM I/II）或晚期（TNM III/IV）期。768例病例可获得流行病学信息和分期。结果：内镜筛查可降低晚期诊断的风险（OR = 0.46，95%CI0.22 -0.98）。年龄较大（> 45岁）与晚期癌症风险降低相关（OR = 0.36，95%CI 0.18-0.74），与结直肠癌有一级亲属相关（OR =0.66，95%CI 0.46-0.95）。农村居民（OR = 1.48，95%CI 1.01-2.17）和非白人（OR = 3.34，95%CI 1.20-9.36）与晚期癌症的风险增加相关。结直肠癌筛查意识和教育计划需要考虑针对最有可能出现晚期结直肠癌的人群。
OBJECTIVES: Colorectal cancer remains a significant cause of mortality and morbidity in North America. Colorectal cancer survival is highly dependent on stage at diagnosis, therefore it is important to identify factors related to stage. This study evaluated the association between subject factors (e.g., colonic screening, family history) and stage of colorectal cancer at diagnosis.METHODS: Population-based colorectal cancer cases recruited by the Ontario Familial Colon Cancer Registry between 1997 and 1999 were staged according to the tumor-nodal-metastasis (TNM) staging system and classified as early (TNM I/II) or late (TNM III/IV) stage. Epidemiologic information and stage was available for 768 cases. Multivariate logistic regression was used to obtain odds ratios (OR) estimates.RESULTS: Having had screening endoscopy reduced the risk of late stage diagnosis (OR = 0.46, 95% CI 0.22-0.98). Being older (> 45 yr) was associated with a reduced risk of late stage cancer (OR = 0.36, 95% CI 0.18-0.74), as was having a first degree relative with colorectal cancer (OR =0.66, 95% CI 0.46-0.95). Rural residence (OR = 1.48, 95% CI 1.01-2.17) and non-white ethnicity (OR = 3.34, 95% CI 1.20-9.36) were associated with an increased risk of late stage cancer.CONCLUSIONS: Several factors are independently associated with late stage colorectal cancer. Colorectal cancer screening awareness and education programs need to consider targeting persons most likely to present with late stage colorectal cancer.