Aliment Pharmacol Ther:预防结直肠癌,阿司匹林是否优于结肠镜或FOBT?

2016-11-21 MedSci MedSci原创

使用阿司匹林、软式乙状结肠镜或愈创木脂粪便潜血试验(FOBT)筛查,均可以降低结直肠癌死亡率,但没有对这些干预措施的有效性进行比较。 本项网络荟萃分析比较了阿司匹林和软式乙状结肠镜或愈创木脂FOBT筛查对结直肠癌发病率和死亡率的影响。 我们检索了MEDLINE,EMBASE和Cochrane等数据库中相关的随机对照试验。随机试验报告了平均风险人群的结直肠癌死亡率、发病率或两者均有,且随

使用阿司匹林、软式乙状结肠镜或愈创木脂粪便潜血试验(FOBT)筛查,均可以降低结直肠癌死亡率,但没有对这些干预措施的有效性进行比较。

本项网络荟萃分析比较了阿司匹林和软式乙状结肠镜或愈创木脂FOBT筛查对结直肠癌发病率和死亡率的影响。

我们检索了MEDLINE,EMBASE和Cochrane等数据库中相关的随机对照试验。随机试验报告了平均风险人群的结直肠癌死亡率、发病率或两者均有,且随访至少2年,样本量超过100。

阿司匹林与FOBT (RR 1.03; 95% PrI 0.76–1.39)或软式乙状结肠镜检查(RR 1.16; 95% PrI 0.84–1.60)比较,结直肠癌死亡率方面的影响是相似的。

预防近端结肠癌死亡方面,使用阿司匹林比FOBT (RR 0.36; 95% PrI 0.22–0.59)和乙状结肠镜检查(RR 0.37; 95% PrI 0.22–0.62)更有效。

阿司匹林和筛查方法均可以减少结直肠癌发病率,不过乙状结肠镜检查优于FOBT (RR 0.84; 95% PrI 0.72–0.97)。

降低结直肠癌的发病率和死亡率方面,低剂量阿司匹林似乎和软式乙状结肠镜或愈创木脂FOBT筛查同样有效,并且预防近端结肠癌症更有效。

原始出处:

L. Emilsson, Ø. Holme, M. Bretthauer, N. R. Cook, J. E. Buring, M. Løberg, H.-O. Adami, H. D. Sesso, M. J. Gaziano and M. Kalager.Systematic review with meta-analysis: the comparative effectiveness of aspirin vs. screening for colorectal cancer prevention.Aliment Pharmacol Ther.17 NOV 2016

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    2017-03-08 jj000001
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    2017-09-29 仁医06
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    2016-11-23 yxtcm.best

    临床意义有待商榷,肠镜检查临床接受度还可以

    0

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    2016-11-23 zhouqu_8
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