摘要
目的评价连续3轮次年度粪便免疫化学试验(FIT)在中国人群结直肠癌筛查中的参与率和结直肠病变检出情况。方法基于2018年5月至2021年5月在全国6个中心开展的一项人群结直肠癌筛查研究,共纳入了7793例50~74岁符合研究条件的受试者,为其提供免费的FIT检测和结肠镜检查(仅针对FIT初筛阳性者)。在基线时,所有受试者均受邀接受FIT筛查。在后续轮次筛查中,仅邀请FIT阳性但未接受结肠镜检查者或FIT阴性者进行重复FIT筛查。FIT阳性者推荐接受结肠镜和病理检查(如结肠镜下有异常发现)。研究共计开展了3轮次每年1次的FIT筛查,主要研究结局为FIT参与率、FIT阳性者的结肠镜检查参与率以及结直肠肿瘤的检出率。结果7793例受试者中男3310人(42.5%),年龄为(60.50±6.49)岁。第1轮、第2轮和第3轮FIT筛查的参与率分别为94.0%(7327/7793)、86.8%(6048/6968)和91.3%(6113/6693)。在7793例参与者中,99.3%(7742/7793)参加了至少1轮筛查,66.3%(5163/7793)参加了全部3轮筛查。第1轮筛查人群的FIT阳性率(14.6%,1071/7327)高于第2轮(5.6%,341/6048)和第3轮(5.5%,339/6113)筛查(均P<0.001)。FIT阳性受试者结肠镜检查依从率在3轮筛查中均达到70%以上,分别为76.3%(817/1071)、75.7%(258/341)和71.7%(243/339)。logistic多因素回归分析显示,性别和吸烟状态是影响FIT筛查参与率的影响因素,男性和不吸烟者的FIT筛查参与率较高。此外,年龄与FIT阳性者的结肠镜检查依从率呈负相关。经过3轮筛查,进展期肿瘤(结直肠癌+进展期腺瘤)的检出率逐轮下降[第1轮:1.15%(90/7793);第2轮:0.57%(40/6968);第3轮:0.58%(39/6693)],但进展期肿瘤的阳性预测值逐轮增加,分别为11.02%、15.50%和16.05%。在各轮次筛查中,男性病变检出率均高于女性,且检出率均随着年龄增长而增加。结论每年1次的重复FIT筛查在中国人群中具有较好的接受度以及较高的病变检出率。为了优化和提升�
Objective To evaluate the participation rate and detection of colorectal neoplasms based on annual fecal immunochemical testing(FIT)for three consecutive years in a population-based colorectal cancer screening program in China.Methods Based on a population-based colorectal cancer screening program conducted from May 2018 to May 2021 in 6 centers in China,7793 eligible participants aged 50-74 were included and offered free FIT and colonoscopy(for those who were FIT-positive on initial screening).At baseline,all participants were invited to receive FIT.In subsequent screening rounds,only FIT-positive participants who did not undergo colonoscopy or FIT-negative participants were invited to have repeated FIT screening.FIT-positive participants were recommended to undertake colonoscopy and pathological examination(if abnormalities were found during colonoscopy).An overall of three rounds of annual FIT screening were conducted.The primary outcomes of the study were the participation rate of FIT screening,the compliance rate of colonoscopy for FIT-positive participants,and the detection rate of colorectal neoplasms.Results Among the 7793 participants included in this study,3310(42.5%)were male,with age of(60.50±6.49)years.The overall participation rates for the first,second and third round of FIT screening were 94.0%(7327/7793),86.8%(6048/6968)and 91.3%(6113/6693),respectively.Overall,7742 out of 7793 participants(99.3%)attended at least one round of screening,and 5163 out of 7793 participants(66.3%)attended all three rounds of screening.The positivity rate was significantly higher in the first(14.6%,1071/7327)round compared with the second(5.6%,341/6048)and third(5.5%,339/6113)screening rounds(P<0.001).The overall compliance rates of colonoscopy examination among FIT-positive subjects were over 70%in three rounds,which were 76.3%(817/1071),75.7%(258/341)and 71.7%(243/339),respectively.In a multivariate logistic regression model considering factors including sex,education background,smoking,alcohol drinking,previous co
作者
李娜
周月阳
卢明
张愉涵
陆斌
骆晨雨
骆家辉
蔡洁
陈宏达
代敏
Li Na;Zhou Yueyang;Lu Ming;Zhang Yuhan;Lu Bin;Luo Chenyu;Luo Jiahui;Cai Jie;Chen Hongda;Dai Min(Department of Cancer Epidemiology,National Cancer Center/National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100021,China;Center for Prevention and Early Intervention,National Infrastructures for Translational Medicine,Institute of Clinical Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100730,China;Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2023年第12期1041-1050,共10页
Chinese Journal of Oncology
基金
中国医学科学院医学与健康科技创新工程(2017-I2M-1-006、2022-I2M-1-003)
国家自然科学基金(82173606、82273726)。
关键词
结直肠肿瘤
筛查
粪便潜血检测
参与率
检出率
Colorectal neoplasms
Screening
Fecal occult blood testing
Participation
Detection rate
