从粪便潜血试验筛查阳性到结肠镜检查的时间与肿瘤形成风险
Time from positive screening fecal occult blood test to colonoscopy and risk of neoplasia.
作者信息
Gellad Ziad F, Almirall Daniel, Provenzale Dawn, Fisher Deborah A
机构信息
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC 27710, USA.
出版信息
Dig Dis Sci. 2009 Nov;54(11):2497-502. doi: 10.1007/s10620-008-0653-8. Epub 2008 Dec 18.
Abstract
There is no guideline defining the optimal time from a positive screening fecal occult blood test to follow-up colonoscopy. We reviewed records of 231 consecutive primary care patients who received a colonoscopy within 18 months of a positive fecal occult blood test. We examined the relationship between time to colonoscopy and risk of neoplasia on colonoscopy using a logistic regression analysis adjusting for potential confounders such as age, race, and gender. The mean time to colonoscopy was 236 days. Longer time to colonoscopy (OR = 1.10, P = 0.01) and older age (OR 1.04, P = 0.01) were associated with higher odds of neoplasia. The association of time with advanced neoplasia was positive, but not statistically significant (OR 1.07, P = 0.14). In this study, a longer interval to colonoscopy after fecal occult blood test was associated with an increased risk of neoplasia. Determining the optimal interval for follow-up is desirable and will require larger studies.
摘要
目前尚无指南明确规定从粪便潜血试验阳性到后续结肠镜检查的最佳时间。我们回顾了231例连续的初级保健患者的记录，这些患者在粪便潜血试验阳性后的18个月内接受了结肠镜检查。我们使用逻辑回归分析，对年龄、种族和性别等潜在混杂因素进行调整，研究结肠镜检查时间与结肠镜检查时肿瘤形成风险之间的关系。结肠镜检查的平均时间为236天。结肠镜检查时间较长（OR = 1.10，P = 0.01）和年龄较大（OR 1.04，P = 0.01）与肿瘤形成的较高几率相关。时间与晚期肿瘤形成的关联呈阳性，但无统计学意义（OR 1.07，P = 0.14）。在本研究中，粪便潜血试验后结肠镜检查间隔时间较长与肿瘤形成风险增加相关。确定最佳随访间隔是可取的，这将需要更大规模的研究。
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