■与直接筛查结肠镜检查相比,粪便免疫化学测试(FIT)阳性后腺瘤检出率(ADR)更高。
■这项荟萃分析评估了ADR,晚期腺瘤检出率(AADR),结直肠癌检测(CDR),和无柄锯齿状病变检测(SSLDR)受不同FIT阳性阈值的影响。
■我们搜索了MEDLINE,EMBASE,CINAHL,和EBM审查报告ADR的研究数据库,AADR,CDR,根据50-74岁无症状平均风险个体的不同FIT截止值和SSLDR。数据按性别分层,年龄,结肠镜检查的时间,出版年份,大陆,和FIT套件类型。学习质量,异质性,并评估发表偏倚.
■总的来说,检索到4280篇文章,纳入58项研究(277,661FIT阳性结肠镜检查;平均盲肠插管96.3%;平均年龄60.8岁;男性52.1%)。平均不良反应为56.1%(95%CI53.4-58.7%),虽然意味着AADR,CDR,SSLDR为27.2%(95%CI24.4-30.1%),5.3%(95%CI4.7-6.0%),和3.0%(95%CI1.7-4.6%),分别。FIT截止水平每增加20μgHb/g,ADR增加1.54%(95%CI0.52-2.56%,p<0.01),AADR下降3.90%(95%CI2.76-5.05%,p<0.01)和CDR下降1.46%(95%CI0.66-2.24%,p<0.01)。在男性和欧洲人中,许多检出率更高。
■FIT阳性结肠镜检查中的不良反应受采用的FIT阳性阈值的影响,并确定了目标,重要的是,被证明高于大多数当前的社会建议。
UNASSIGNED: Adenoma detection rate (ADR) is higher after a positive fecal immunochemical test (FIT) compared to direct screening colonoscopy.
UNASSIGNED: This meta-analysis evaluated how ADR, the rates of advanced adenoma detection (AADR), colorectal cancer detection (CDR), and sessile serrated lesion detection (SSLDR) are affected by different FIT positivity thresholds.
UNASSIGNED: We searched MEDLINE, EMBASE, CINAHL, and EBM Reviews databases for studies reporting ADR, AADR, CDR, and SSLDR according to different FIT cut-off values in asymptomatic average-risk individuals aged 50-74 years old. Data were stratified according to sex, age, time to colonoscopy, publication year, continent, and FIT kit type. Study quality, heterogeneity, and publication bias were assessed.
UNASSIGNED: Overall, 4280 articles were retrieved and fifty-eight studies were included (277,661 FIT-positive colonoscopies; mean cecal intubation 96.3%; mean age 60.8 years; male 52.1%). Mean ADR was 56.1% (95% CI 53.4 - 58.7%), while mean AADR, CDR, and SSLDR were 27.2% (95% CI 24.4 - 30.1%), 5.3% (95% CI 4.7 - 6.0%), and 3.0% (95% CI 1.7 - 4.6%), respectively. For each 20 μg Hb/g increase in FIT cut-off level, ADR increased by 1.54% (95% CI 0.52 - 2.56%, p < 0.01), AADR by 3.90% (95% CI 2.76 - 5.05%, p < 0.01) and CDR by 1.46% (95% CI 0.66 - 2.24%, p < 0.01). Many detection rates were greater amongst males and Europeans.
UNASSIGNED: ADRs in FIT-positive colonoscopies are influenced by the adopted FIT positivity threshold, and identified targets, importantly, proved to be higher than most current societal recommendations.