Wada T, Saito H, Soma Y, Koeda J, Kawaguchi H, Tanaka M, Yoshida Y, Munakata A
HIROSAKI UNIV,SCH MED,DEPT INTERNAL MED 1,HIROSAKI,AOMORI 036,JAPAN. HIROSAKI UNIV,SCH MED,DEPT PATHOL 2,HIROSAKI,AOMORI 036,JAPAN.
Int J Oncol. 1996 Oct;9(4):685-91. doi: 10.3892/ijo.9.4.685.
The effectiveness of screening for colorectal cancer by an immunochemical fecal occult blood test was investigated by comparing the survival time of 194 screen-detected colorectal cancer subjects (screen-detected group) with that of 352 routinely diagnosed subjects (control group). The rate of Dukes' A cancers was significantly higher in screen-detected group than in the control group (43.8% vs 16.8%, p<0.0001), whereas that of Dukes' D cancer was the opposite (5.7% vs 21.3%, p<0.0001). The survival rate for screen-detected group was higher than that for the control group (Kaplan-Meier method, p<0.0001). By a proportional hazard model with adjustment for prognostic factors except stage, the risk ratio of death from colorectal cancer was 0.40 (p=0.0007) for screen-detected group versus the control group. Therefore, the screening was suggested to be effective in survival benefit, although there might be potential biases inherent in observational studies.
通过比较194名经筛查发现的结直肠癌患者（筛查发现组）和352名常规诊断患者（对照组）的生存时间，研究了免疫化学粪便潜血试验筛查结直肠癌的有效性。筛查发现组中杜克A期癌症的比例显著高于对照组（43.8%对16.8%，p<0.0001），而杜克D期癌症的比例则相反（5.7%对21.3%，p<0.0001）。筛查发现组的生存率高于对照组（Kaplan-Meier法，p<0.0001）。通过对除分期外的预后因素进行调整的比例风险模型，筛查发现组与对照组相比，结直肠癌死亡的风险比为0.40（p=0.0007）。因此，尽管观察性研究可能存在潜在偏差，但该筛查被认为在生存获益方面是有效的。
