Department of Gastroenterology, Ospedale Santa Chiara, APSS, Trento, Italy.
Gastrointest Endosc. 2011 Mar;73(3):527-534.e2. doi: 10.1016/j.gie.2010.12.025.
A screening colonoscopy is recommended in first-degree relatives (FDRs) of colorectal cancer patients; few prospective, controlled studies have evaluated colorectal findings in a population-based screening program.
To evaluate the prevalence of colorectal neoplasia (adenomas and adenocarcinomas) in this increased-risk population, to compare it with that of average-risk individuals, and to identify features that might allow risk stratification for neoplasia among FDRs.
Cross-sectional study.
Population-based screening program in Trentino, Italy.
FDRs of colorectal cancer patients between 45 and 75 years of age with no history of hereditary colorectal cancer syndromes or inflammatory bowel disease.
Average-risk individuals undergoing screening colonoscopy.
Screening colonoscopy.
Neoplasia was found in 33.4% of 1252 FDRs and in 30.3% of 765 controls; advanced neoplasia was found in 11.3% of FDRs and in 6.3% of controls. Odds ratios (ORs) from the multivariate logistic regression analysis adjusted for age, sex, cecal intubation rates, and colon cleansing showed an increased risk of advanced neoplasia (OR 2.41; 95% CI, 1.69-3.43; P < .0001) in FDRs. Age older than 56 years (OR 1.83; 95% CI, 1.15-2.99; P = .013) and male sex (OR 2.17; 95% CI, 1.39-3.10; P < .001) are independent predictors of advanced neoplasia.
Italian subjects living in the same geographic area; of 4301 FDRs, 2521 were excluded.
The increased risk of advanced neoplasia supports the current recommendation for colonoscopic screening in this group; age and sex may assist in risk stratification of these individuals.
建议对结直肠癌患者的一级亲属（FDRs）进行筛查性结肠镜检查；但很少有前瞻性、对照研究在基于人群的筛查计划中评估 FDRs 的结直肠发现。
评估在这个高危人群中结直肠肿瘤（腺瘤和腺癌）的患病率，并与普通风险个体进行比较，并确定可能允许对 FDRs 中肿瘤进行风险分层的特征。
横断面研究。
意大利特伦蒂诺的基于人群的筛查计划。
年龄在 45 至 75 岁之间、无遗传性结直肠癌综合征或炎症性肠病病史的结直肠癌患者的 FDRs。
接受筛查性结肠镜检查的普通风险个体。
筛查性结肠镜检查。
在 1252 名 FDRs 中发现了 33.4%的肿瘤，在 765 名对照组中发现了 30.3%的肿瘤；在 FDRs 中发现了 11.3%的高级别肿瘤，在对照组中发现了 6.3%的高级别肿瘤。多变量逻辑回归分析调整年龄、性别、盲肠插管率和结肠清洗后显示，FDRs 中高级别肿瘤的风险增加（OR 2.41；95%CI，1.69-3.43；P<0.0001）。年龄大于 56 岁（OR 1.83；95%CI，1.15-2.99；P=0.013）和男性（OR 2.17；95%CI，1.39-3.10；P<0.001）是高级别肿瘤的独立预测因子。
意大利生活在同一地理区域的受试者；在 4301 名 FDRs 中，有 2521 名被排除在外。
高级别肿瘤的风险增加支持目前对该人群进行结肠镜筛查的建议；年龄和性别可能有助于对这些个体进行风险分层。
