Saito H, Soma Y, Nakajima M, Koeda J, Kawaguchi H, Kakizaki R, Chiba R, Aisawa T, Munakata A
First Department of Internal Medicine, Hirosaki University, School of Medicine, Hirosaki 036-8562, Japan.
Oncol Rep. 2000 Jul-Aug;7(4):815-9. doi: 10.3892/or.7.4.815.
A case control study to evaluate the occult blood screening for colorectal cancer was conducted in a town where colorectal cancer screening had been performed by Hemoccult test during the early years and subsequently by an immunochemical hemagglutination test. All residents aged >/=40 years had been offered the annual screening. Case series consisted of 51 subjects with fatal colorectal cancer. Three controls per case were selected from the list of residents who were alive at the time of diagnosis of the corresponding case and had been living in the town, matched by gender and by age. The odds ratio (OR) of dying of colorectal cancer for those having their most recent screening histories with Hemoccult test or the immunochemical test during the preceding 1 year and 1-2 year segment before case diagnosis were 0.20 [95% confidence interval (CI): 0.08-0.49] and 0. 17 (95% CI: 0.04-0.75), respectively. The OR increased towards 1.0 as the number of years since the most recent screening increased. The OR of dying of colorectal cancer was calculated to be 0.19 (95% CI: 0.05-0.70) for those screened with the immunochemical test alone during the preceding 1 year after adjustment for previous screening histories with the Hemoccult test. Corresponding OR was 0.36 (95% CI: 0.11-1.17) for those screened with Hemoccult test during the preceding 1 year. These results suggest that screening for colorectal cancer by fecal occult blood testings or immunochemical test alone would reduce mortality and that efficacy of the screening would be higher for the immunochemical test than for Hemoccult test.
在一个小镇开展了一项病例对照研究，以评估结直肠癌潜血筛查情况。早年该小镇通过隐血试验进行结直肠癌筛查，随后采用免疫化学血凝试验。所有年龄≥40岁的居民均接受年度筛查。病例组包括51例致命性结直肠癌患者。每个病例选取3名对照，从相应病例诊断时仍在世且居住在该小镇的居民名单中选取，按性别和年龄匹配。在病例诊断前1年以及1 - 2年期间，最近一次筛查采用隐血试验或免疫化学试验的人群死于结直肠癌的比值比（OR）分别为0.20 [95%置信区间（CI）：0.08 - 0.49]和0.17（95% CI：0.04 - 0.75）。随着距最近一次筛查时间的增加，OR值趋向于1.0。在对既往隐血试验筛查史进行校正后，前1年单独采用免疫化学试验筛查的人群死于结直肠癌的OR值经计算为0.19（95% CI：0.05 - 0.70）。前1年采用隐血试验筛查的人群相应的OR值为0.36（95% CI：0.11 - 1.17）。这些结果表明，单独通过粪便潜血试验或免疫化学试验进行结直肠癌筛查可降低死亡率，且免疫化学试验的筛查效果高于隐血试验。
