Goodyear S J, Stallard N, Gaunt A, Parker R, Williams N, Wong L
Department of Surgery, University Hospitals, Coventry and Warwickshire NHS Trust, Coventry, UK.
Br J Surg. 2008 Sep;95(9):1172-9. doi: 10.1002/bjs.6230.
The English arm of the UK Bowel Cancer Screening Pilot study recently concluded its third round. The primary aim was to assess the impact of faecal occult blood test (FOBT) screening on the detection of symptomatic (non-screen-detected) cancers within the target age group (50-69 years). The secondary aim was to assess differences between screened and non-screened cohorts in Dukes' classification at diagnosis.
This population-based study utilized retrospective analysis of existing validated colorectal cancer (CRC) data over 5 years (April 2000 to March 2005), encompassing rounds one and two of screening.
There was a 23 per cent (P = 0.011) reduction in the diagnosis of over the 5 years. Presentations with symptomatic cancer reduced by 49 per cent (P = 0.049), with a proportionate (2.6-fold) rise in the detection of screened (asymptomatic) malignancy. Cancers were diagnosed at an earlier stage in the screened population, with significantly more Dukes' A tumours than in the non-screen-detected cohort (P < 0.001) and an estimated odds ratio of 0.27 (95 per cent confidence interval 0.08 to 0.91) (P = 0.035) for Dukes' 'D' cancers.
FOBT screening resulted in a significant reduction in the number of symptomatic cancers detected within the target age group. Tumours detected by screening were diagnosed at an earlier pathological stage.
英国肠癌筛查试点研究的英国部分最近完成了第三轮筛查。主要目的是评估粪便潜血试验（FOBT）筛查对目标年龄组（50 - 69岁）中有症状（非筛查发现）癌症检测的影响。次要目的是评估筛查组和未筛查组在诊断时Dukes分期的差异。
这项基于人群的研究利用了对5年（2000年4月至2005年3月）现有经过验证的结直肠癌（CRC）数据的回顾性分析，涵盖了第一轮和第二轮筛查。
在这5年中，癌症诊断率下降了23%（P = 0.011）。有症状癌症的病例减少了49%（P = 0.049），筛查出的（无症状）恶性肿瘤的检测率相应上升（2.6倍）。在筛查人群中，癌症在更早阶段被诊断出来，Dukes A期肿瘤比未筛查发现的队列显著更多（P < 0.001），Dukes 'D'期癌症的估计比值比为0.27（95%置信区间0.08至0.91）（P = 0.035）。
FOBT筛查导致目标年龄组中有症状癌症的检测数量显著减少。通过筛查检测出的肿瘤在更早的病理阶段被诊断出来。
