MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK.
Diabetologia. 2011 Feb;54(2):312-9. doi: 10.1007/s00125-010-1949-8. Epub 2010 Oct 27.
AIMS/HYPOTHESIS: The aim of this study was to assess the impact of invitation to screening for type 2 diabetes and related cardiovascular risk factors on population mortality.
This was a parallel-group population-based cohort study including all men and women aged 40-65 years, free of known diabetes, registered with a single practice in Ely, UK (n = 4,936). In 1990-1992, approximately one-third (n = 1,705) were randomly selected to receive an invitation to screening for diabetes (with an OGTT) and related cardiovascular risk factors. In the remaining two-thirds of the population, 1,705 individuals were randomly selected for invitation to screening in 2000-2003 and 1,526 were not invited at any point during the follow-up period. All individuals were flagged for mortality until January 2008.
There were 345 deaths between 1990 and 1999 (median 10 years follow-up). Compared with those not invited, individuals who were invited to the 1990-1992 screening round had a non-significant 21% lower all-cause mortality (HR 0.79 [95% CI 0.63-1.00], p = 0.05) after adjustment for age, sex and deprivation. There were 291 deaths between 2000 and 2008 (median 8 years follow-up), with no significant difference in mortality between invited and non-invited participants in 2000-2003. Compared with the non-invited group, participants who attended for screening at any time point had a significantly lower mortality and those who did not attend had a significantly higher mortality.
CONCLUSIONS/INTERPRETATION: Invitation to screening was associated with a non-significant reduction in mortality in the Ely cohort between 1990 and 1999, but this was not replicated in the period 2000-2008. This study contributes to the evidence concerning the potential benefits of population screening for diabetes and related cardiovascular risk factors.
目的/假设：本研究旨在评估邀请进行 2 型糖尿病及相关心血管风险因素筛查对人群死亡率的影响。
这是一项基于人群的平行组队列研究，纳入了英国伊利市所有年龄在 40-65 岁、无已知糖尿病且在单一诊所登记的男性和女性（n=4936）。1990-1992 年，大约三分之一（n=1705）的人被随机选中，邀请他们进行糖尿病（OGTT）及相关心血管风险因素筛查。在人群的另外三分之二，2000-2003 年随机挑选 1705 人邀请筛查，随访期间，1526 人未被邀请。所有参与者的死亡情况都被标记，直到 2008 年 1 月。
1990 年至 1999 年期间有 345 人死亡（中位随访时间 10 年）。与未被邀请者相比，1990-1992 年筛查轮次中被邀请者的全因死亡率显著降低 21%（HR 0.79 [95% CI 0.63-1.00]，p=0.05），校正年龄、性别和贫困程度后。2000 年至 2008 年期间有 291 人死亡（中位随访时间 8 年），2000-2003 年邀请和未邀请参与者之间的死亡率无显著差异。与未被邀请者相比，任何时间点接受筛查的参与者死亡率显著降低，未参加筛查者死亡率显著升高。
结论/解释：邀请参加筛查与 1990 年至 1999 年期间伊利队列的死亡率降低呈非显著相关，但在 2000-2008 年期间未得到重复。本研究为有关糖尿病及相关心血管风险因素人群筛查潜在益处的证据做出了贡献。
