■我们进行了一项综合分析,以比较结肠镜检查和乙状结肠镜检查与标准护理或粪便免疫化学有关结直肠癌发生率和死亡风险。
■直到2023年8月,PubMed的文献,Embase,WebofScience,并对Cochrane进行了系统评价。我们检查了结肠镜或乙状结肠镜检查与标准治疗对结直肠癌预后的影响,包括发病率,癌症特异性死亡率,和总死亡率。
■在4,265篇筛选的文章中,对7项随机对照试验(663,319名参与者)的数据进行了分析.干预组(结肠镜检查或乙状结肠镜检查)由258,938名参与者组成,而对照组接受标准护理或粪便免疫化学检测,共有404381名参与者,两组都有平均的结直肠癌风险,没有混淆。汇总分析表明,与标准护理相比,干预组的结直肠癌发病率降低了20%(RR:0.80,95%CI:0.77-0.83),结直肠癌死亡率降低了26%(RR:0.74,95%CI:0.69-0.80)。全因死亡率保持不变(RR:1.03,95%CI:0.99-1.07)。亚组分析有利于乙状结肠镜检查降低结直肠癌发病率和死亡率。
■这项随机对照试验的荟萃分析强调了结肠镜检查的有效性,特别是,乙状结肠镜检查在平均风险人群中降低结直肠癌发病率和死亡率。与粪便免疫化学测试相比,结肠镜和乙状结肠镜对该人群结直肠癌的发病率和死亡率均无显著影响.
■https://www.crd.约克。AC.英国/PROSPERO/,标识符CRD42023460007。
UNASSIGNED: We conducted a comprehensive analysis to compare colonoscopy and
sigmoidoscopy with standard care or fecal immunochemistry regarding colorectal cancer incidence and mortality risk.
UNASSIGNED: Until August 2023, literature from PubMed, Embase, Web of Science, and Cochrane was systematically reviewed. We examined the impact of colonoscopy or
sigmoidoscopy versus standard care on colorectal cancer outcomes, including incidence, cancer-specific mortality, and overall mortality.
UNASSIGNED: Among 4,265 screened articles, data from seven randomized controlled trials (involving 663,319 participants) were analyzed. The intervention group (colonoscopy or
sigmoidoscopy) consisted of 258,938 participants, while the control group received standard care or fecal immunochemical testing, totaling 404,381 participants, with both groups having average colorectal cancer risk, without confounders. Pooled analyses indicated a 20% reduction in colorectal cancer incidence (RR: 0.80, 95% CI: 0.77-0.83) and a 26% decrease in colorectal cancer mortality (RR: 0.74, 95% CI: 0.69-0.80) in the intervention group compared to standard care. All-cause mortality remained unchanged (RR: 1.03, 95% CI: 0.99-1.07). Subgroup analysis favored
sigmoidoscopy in reducing colorectal cancer morbidity and mortality.
UNASSIGNED: This meta-analysis of randomized controlled trials underscores the effectiveness of colonoscopy and, notably, sigmoidoscopy in reducing colorectal cancer incidence and mortality among average-risk populations. In comparison to fecal immunochemical testing, both colonoscopy and
sigmoidoscopy did not significantly impact colorectal cancer incidence and mortality in this population.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023460007.