背景:结直肠癌(CRC)筛查计划B-PREDICT是一个基于人群的邀请两阶段筛查项目,使用粪便免疫化学测试(FIT)进行初始筛查,然后对FIT阳性的患者进行结肠镜检查。B-PREDICT与机会性结肠镜检查(OPP-COL)进行比较,在全国范围的筛查计划中进行。
方法:在B-PREDICT中,奥地利联邦州Burgenland的所有居民,每年邀请40至80岁的人参加FIT测试。在2003年1月至2014年12月12日期间在Burgenland接受初次结肠镜检查的所有个体均纳入本研究。将来自FIT触发的邀请筛查计划B-PREDICT的个体与非FIT触发的OPP-COL的个体进行比较。
结果:将来自B-PREDICT的15133名个体与OPP-COL的10045名个体进行了比较。CRC检出率为1.34%(CI-95%,B-预测中的[1.15;1.52])与OPP-COL中的0.54%相比(95%-CI,[0.39;0.68]p<0.001)。在接受FIT筛查的人群中,与接受结肠镜检查的普通人群相比,年龄标准化的CRC发病率下降更为明显。每年的发病率变化为-4.4%(95%-CI,[-5.1;-3.7])与-1.8%(95%-CI,[-1.9;-1.6]p<0.001)。
结论:与OPP-COL相比,B-PREDICT显示CRC和HRA的检出率高两倍。
BACKGROUND: The colorectal cancer (CRC) screening program B-PREDICT is a population based invited two stage screening project using a faecal immunochemical test (FIT) for initial screening followed by a colonoscopy for those with a positive FIT. B-PREDICT was compared with the opportunistic screening colonoscopy (OPP-COL), performed in course of the nationwide screening program.
METHODS: Within B-PREDICT all residents of the Austrian federal state Burgenland, aged between 40 and 80 are annually invited to FIT testing. All individuals who underwent initial colonoscopy in Burgenland between 01/2003 and 12/2014, were included in this
study. Individuals from the FIT-triggered invited screening program B-PREDICT were compared with those from the non-FIT triggered OPP-COL.
RESULTS: 15 133 individuals from B-PREDICT were compared to 10 045 individuals with OPP-COL. CRC detection rates were 1.34% (CI-95%, [1.15; 1.52]) in B-PREDICT compared to 0.54% in OPP-COL (95%-CI, [0.39; 0.68] p < 0.001). The decrease in the age standardized incidence rates of CRC was more pronounced in the population screened with FIT than in the general population screened with colonoscopy. Changes in incidence rates per year were -4.4% (95%-CI, [-5.1; -3.7]) vs. -1.8% (95%-CI, [-1.9; -1.6] p < 0.001).
CONCLUSIONS: B-PREDICT shows a two-fold higher detection rate of CRC as well as HRA compared to OPP-COL.