Lancet子刊:担心肠癌却又不敢做肠镜?这种替代方法可能同样有效!

2022-03-24 MedSci原创 MedSci原创

在世界范围内,结直肠癌(CRC)是女性中第二常见、男性中第三常见的癌症,在2012年造成了69多万例死亡。

在世界范围内,结直肠癌(CRC)是女性中第二常见、男性中第三常见的癌症,在2012年造成了69多万例死亡。在美国,CRC是癌症死亡的第二大病因,CRC引起的死亡约占总体癌症死亡的8.4%。大约每3例CRC患者中有1例会因此死亡。

有一个令人欣慰的现象便是,最近几年来,大家普遍认识到筛查预防CRC一个十分重要的措施。在2004-2013年间,CRC的死亡率平均每年下降2.7%。微观模拟模型MISCAN-Colon提示,所观察到的CRC死亡率下降,可能约有53%得益于CRC筛查。

CRC的筛查是通过下消化道内窥镜检查或基于粪便的测试进行的。很少有随机试验的证据显示初级结肠镜检查能降低结直肠癌的死亡率。近期,来自瑞典卡罗林斯卡学院的专家旨在研究只做一次结肠镜检查或两轮粪便免疫化学试验筛查对CRC死亡率和发病率的影响,结果发表在Lancet Gastroenterology&Hepatology杂志上。

研究人员在瑞典进行了一项随机对照试验(SCREESCO)。在21个地区中,有18个地区的居民在随机化的那一年年满60岁,随机分配到只做一次结肠镜检查、两轮粪便免疫化学检测(OC-Sensor;间隔2年)或对照组(无干预;标准诊断途径)。试验的主要终点是结直肠癌的死亡率和结直肠癌的发病率。

在2014年3月1日至2020年12月31日期间,有278280人被纳入研究;31140人被分配到结肠镜检查组,60300人被分配到粪便免疫化学检验组,186840人被分配到对照组。在收到结肠镜检查邀请的30400人中,有10679人(35.1%)参加。60137名收到邮寄的粪便免疫化学检验的人中有33383人(55.5%)参加。

在意向性分析中,结肠镜检查组31140人中有49人(0.16%)检测出结肠癌,而粪便免疫化学检测组60300人中有121人(0.20%)检测出结肠癌,结果并没有差异(RR=0.78,95% CI 0.56-1.09)。结肠镜检查组有637人(2.05%)检测到晚期腺瘤,而粪便免疫化学检测组有968人(1.61%)(RR 1.27,95% CI 1.15-1.41)。结肠镜检查比粪便免疫化学检验发现更多的右侧晚期腺瘤。

由此可见,只做一次结肠镜检查和两次粪便免疫化学检测筛查,都可以用于人群的CRC筛查服务。

 

参考文献:

Once-only colonoscopy or two rounds of faecal immunochemical testing 2 years apart for colorectal cancer screening (SCREESCO): preliminary report of a randomised controlled trial. https://doi.org/10.1016/S2468-1253(21)00473-8

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1831512, encodeId=3afc1831512c8, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Apr 09 10:19:12 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1206376, encodeId=9b5712063e664, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Sun Mar 27 15:21:49 CST 2022, time=2022-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434537, encodeId=3433143453e4f, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 26 05:19:12 CST 2022, time=2022-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205901, encodeId=bab61205901bd, content=这个结论对临床太有价值了, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220325/2e5c1446e1f6401887a00a17729e6faf/3c0410fc6eab4ea19ea9a1c32232cf25.jpg, createdBy=b9e41331726, createdName=zengrongsuiyue, createdTime=Fri Mar 25 17:50:28 CST 2022, time=2022-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205737, encodeId=506a1205e3700, content=早发现早治疗,比什么都好, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FmSkFibQfjYMxiaIoWSBONhIBNVwKqdqDibyWbfMNDw27fBeu5lbS6KGUpPzjopGJK3VuHIDvIYsO1ruUmm03XC0g/132, createdBy=a1b55310798, createdName=A型夹层, createdTime=Fri Mar 25 00:39:40 CST 2022, time=2022-03-25, status=1, ipAttribution=)]
    2022-04-09 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1831512, encodeId=3afc1831512c8, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Apr 09 10:19:12 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1206376, encodeId=9b5712063e664, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Sun Mar 27 15:21:49 CST 2022, time=2022-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434537, encodeId=3433143453e4f, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 26 05:19:12 CST 2022, time=2022-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205901, encodeId=bab61205901bd, content=这个结论对临床太有价值了, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220325/2e5c1446e1f6401887a00a17729e6faf/3c0410fc6eab4ea19ea9a1c32232cf25.jpg, createdBy=b9e41331726, createdName=zengrongsuiyue, createdTime=Fri Mar 25 17:50:28 CST 2022, time=2022-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205737, encodeId=506a1205e3700, content=早发现早治疗,比什么都好, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FmSkFibQfjYMxiaIoWSBONhIBNVwKqdqDibyWbfMNDw27fBeu5lbS6KGUpPzjopGJK3VuHIDvIYsO1ruUmm03XC0g/132, createdBy=a1b55310798, createdName=A型夹层, createdTime=Fri Mar 25 00:39:40 CST 2022, time=2022-03-25, status=1, ipAttribution=)]
    2022-03-27 ms2000000182667314

    学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1831512, encodeId=3afc1831512c8, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Apr 09 10:19:12 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1206376, encodeId=9b5712063e664, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Sun Mar 27 15:21:49 CST 2022, time=2022-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434537, encodeId=3433143453e4f, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 26 05:19:12 CST 2022, time=2022-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205901, encodeId=bab61205901bd, content=这个结论对临床太有价值了, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220325/2e5c1446e1f6401887a00a17729e6faf/3c0410fc6eab4ea19ea9a1c32232cf25.jpg, createdBy=b9e41331726, createdName=zengrongsuiyue, createdTime=Fri Mar 25 17:50:28 CST 2022, time=2022-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205737, encodeId=506a1205e3700, content=早发现早治疗,比什么都好, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FmSkFibQfjYMxiaIoWSBONhIBNVwKqdqDibyWbfMNDw27fBeu5lbS6KGUpPzjopGJK3VuHIDvIYsO1ruUmm03XC0g/132, createdBy=a1b55310798, createdName=A型夹层, createdTime=Fri Mar 25 00:39:40 CST 2022, time=2022-03-25, status=1, ipAttribution=)]
    2022-03-26 zhouqu_8
  4. [GetPortalCommentsPageByObjectIdResponse(id=1831512, encodeId=3afc1831512c8, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Apr 09 10:19:12 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1206376, encodeId=9b5712063e664, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Sun Mar 27 15:21:49 CST 2022, time=2022-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434537, encodeId=3433143453e4f, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 26 05:19:12 CST 2022, time=2022-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205901, encodeId=bab61205901bd, content=这个结论对临床太有价值了, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220325/2e5c1446e1f6401887a00a17729e6faf/3c0410fc6eab4ea19ea9a1c32232cf25.jpg, createdBy=b9e41331726, createdName=zengrongsuiyue, createdTime=Fri Mar 25 17:50:28 CST 2022, time=2022-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205737, encodeId=506a1205e3700, content=早发现早治疗,比什么都好, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FmSkFibQfjYMxiaIoWSBONhIBNVwKqdqDibyWbfMNDw27fBeu5lbS6KGUpPzjopGJK3VuHIDvIYsO1ruUmm03XC0g/132, createdBy=a1b55310798, createdName=A型夹层, createdTime=Fri Mar 25 00:39:40 CST 2022, time=2022-03-25, status=1, ipAttribution=)]
    2022-03-25 zengrongsuiyue

    这个结论对临床太有价值了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1831512, encodeId=3afc1831512c8, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Apr 09 10:19:12 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1206376, encodeId=9b5712063e664, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Sun Mar 27 15:21:49 CST 2022, time=2022-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434537, encodeId=3433143453e4f, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 26 05:19:12 CST 2022, time=2022-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205901, encodeId=bab61205901bd, content=这个结论对临床太有价值了, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220325/2e5c1446e1f6401887a00a17729e6faf/3c0410fc6eab4ea19ea9a1c32232cf25.jpg, createdBy=b9e41331726, createdName=zengrongsuiyue, createdTime=Fri Mar 25 17:50:28 CST 2022, time=2022-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205737, encodeId=506a1205e3700, content=早发现早治疗,比什么都好, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/FmSkFibQfjYMxiaIoWSBONhIBNVwKqdqDibyWbfMNDw27fBeu5lbS6KGUpPzjopGJK3VuHIDvIYsO1ruUmm03XC0g/132, createdBy=a1b55310798, createdName=A型夹层, createdTime=Fri Mar 25 00:39:40 CST 2022, time=2022-03-25, status=1, ipAttribution=)]
    2022-03-25 A型夹层

    早发现早治疗,比什么都好

    0

相关资讯

原来如此,一文读懂肠镜(病理)报告!

我们做肠镜检查,最常见的赘生物就是息肉,其中的腺瘤性息肉,其实就是肠癌的预备状态,90%以上的结直肠癌是它演变而来的。

Dig Dis Sci: 早期结肠镜检查不会增加下消化道出血患者 30 天内的再入院率

下消化道出血 (LGIB) 仍然是目前住院患者中发病率和死亡率的常见原因之一,而经过治疗后的再入院率被认为是医院护理质量的重要指标

DCR: 克罗恩病患者回结肠切除术后 1 个月行内镜评估可预测未来术后复发情况

肠镜是一支细长可弯曲的医学仪器,直径大约1厘米,结肠镜通过肛门进入直肠,直到大肠,可让医生观察到结肠和大肠的内部情况。结肠镜检查是医生用来检查大肠及结肠内部病变的一种诊断方式。

Gastroenterology:结肠镜检查发现高风险腺瘤与无腺瘤患者相比结直肠癌的发生风险和死亡率都会增加

大肠癌(CRC)是世界上第三大最常见的恶性肿瘤,也是与癌症相关的死亡的第四大主要原因。

3分钟看懂,结肠镜病理报告

肠镜是诊断肠道疾病准确、可靠的方法。肠镜检查是将一条长约1.3米、可弯曲、末端装有自带光源电子摄像装置的软管,由肛门慢慢插入大肠进行检查。若有需要,可获取活体组织进行病理学检验。

拓展阅读

European Radiology:高[18F]FDG摄取是否意味着结肠癌患者的预后不良?

阶段,对肿瘤患者进行分期使[18F]FDG PET/CT的常见临床适应证;对于大多数癌症类型来说,原发肿瘤较高的[18F]FDG摄取通常与较高的转移发生率相关。

文献荐读|袁瑛教授:III期结肠癌辅助治疗后奥沙利铂诱导外周神经病变的潜在调节因子

在该项临床研究中,我们试图分析III期肠癌中奥沙利铂诱导外周神经病变(OIPN)与治疗周期、塞来昔布使用、体力活动、BMI、糖尿病状态及维生素B6之间的独立和混杂相关性。

文献荐读|袁瑛教授:可切除结肠癌的术前化疗,一项国际多中心随机对照研究的成熟结果

局部晚期结肠癌治疗中,术前新辅助治疗可能比术后辅助治疗存在潜在的优势,但目前仍需进一步的评估。

文献荐读|袁瑛教授:PEGASUS研究术后液体活检(LB)指导III期及高危II期结肠癌患者的治疗

本期,文献荐读栏目肠癌主编——浙江大学医学院附属第二医院袁瑛教授进行肠癌领域的相关文献荐读。巾帼展“瑛”姿,共赴一场思想之约,以供交流。

PNAS:华中科技大学王桂华/胡俊波等合作发现结肠癌转移的调控新机制

该研究鉴定了NSD2,一种负责将组蛋白3第36位赖氨酸二甲基化的组蛋白甲基转移酶,在转移性肿瘤中过表达。

术后MRD监测为啥要先同时检测肿瘤组织+对照白细胞?这项研究回答你

本研究结果表明,肿瘤DNA和配对WBC测序,不仅可以扩大符合血浆MRD监测条件的患者群体,还可以降低假阳性率。