结直肠癌长期生存者的常规预防保健和癌症监测：来自 National Surgical Adjuvant Breast and Bowel Project Protocol LTS-01 的结果。
Routine preventive care and cancer surveillance in long-term survivors of colorectal cancer: results from National Surgical Adjuvant Breast and Bowel Project Protocol LTS-01.
机构信息
University of California, LosAngeles, CA, USA.
出版信息
J Clin Oncol. 2010 Dec 20;28(36):5274-9. doi: 10.1200/JCO.2010.30.1903. Epub 2010 Nov 15.
PURPOSE
National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol LTS-01 examines routine preventive care and cancer surveillance in long-term colorectal cancer (CRC) survivors previously treated in NSABP adjuvant trials.
PATIENTS AND METHODS
Long-term CRC survivors (≥5 years) from five completed NSABP trials (Protocols C-05, C-06, C-07, R-02, and R-03) at 60 study sites were recruited and surveyed using preventive health care items from the National Health Interview Survey (NHIS). A 3:1 comparison cohort case-matched by age, sex, race, and education was created from the 2005 NHIS. Contingency tables and multivariate models were used to compare cohorts and determine predictors of preventive care and cancer surveillance.
RESULTS
A total of 708 patients in protocol LTS-01 (681 patients with colon cancer, 27 patients with rectal cancer) completed the interview: 57.1% male, mean age 66.2 years (standard deviation=10.6), median survival 8 years. Patients in the LTS-01 protocol were more likely to have a usual source of health care (97.7% v 93.8%, P<.0001), have received a flu shot in the past 12 months (67.5% v 44.3%, P<.0001), and have undergone cancer screening by Pap smear (67.3% v 54.8%, P<.0001), mammogram (80.4% v 70.7%, P<.0001), and prostate-specific antigen test (84.5% v 74.5%, P<.0001) than patients in the NHIS cohort. For CRC surveillance, 96.5% of patients in protocol LTS-01 had a colonoscopy, 88.2% had a carcinoembryonic antigen test, and 66.4% had a computed tomography scan in the previous 5 years. Health insurance was the best predictor of cancer screening for all three methods (odds ratio=2.6 to 4.5). No factor was uniformly associated with CRC surveillance.
CONCLUSION
This select population of long-term CRC survivors who participated in clinical trials achieved better routine preventive care and cancer screening than the general population and high rates of cancer surveillance.
目的
全国外科辅助乳腺和肠道项目（NSABP）协议 LTS-01 检查了之前在 NSABP 辅助试验中接受治疗的长期结直肠癌（CRC）幸存者的常规预防保健和癌症监测。
患者和方法
从五个完成的 NSABP 试验（方案 C-05、C-06、C-07、R-02 和 R-03）的 60 个研究点招募了长期 CRC 幸存者（≥5 年），并使用来自国家健康访谈调查（NHIS）的预防保健项目进行了调查。从 2005 年 NHIS 中创建了一个年龄、性别、种族和教育程度与病例相匹配的 3:1 比较队列。使用列联表和多变量模型比较队列并确定预防保健和癌症监测的预测因素。
结果
协议 LTS-01 中的 708 名患者完成了访谈：57.1%为男性，平均年龄 66.2 岁（标准差=10.6），中位生存期 8 年。LTS-01 方案中的患者更有可能有常规医疗来源（97.7%比 93.8%，P<.0001），在过去 12 个月内接种了流感疫苗（67.5%比 44.3%，P<.0001），并接受了巴氏涂片（67.3%比 54.8%，P<.0001）、乳房 X 光检查（80.4%比 70.7%，P<.0001）和前列腺特异性抗原检测（84.5%比 74.5%，P<.0001）比 NHIS 队列中的患者。对于 CRC 监测，协议 LTS-01 中的 96.5%的患者接受了结肠镜检查，88.2%的患者接受了癌胚抗原检查，66.4%的患者在过去 5 年内接受了计算机断层扫描。健康保险是所有三种方法（比值比=2.6 至 4.5）癌症筛查的最佳预测因素。没有任何因素与 CRC 监测一致。
结论
参与临床试验的这一特定长期 CRC 幸存者人群在常规预防保健和癌症筛查方面优于一般人群，并且癌症监测率很高。
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