HepatoGastroenterology, Centre Hospitalier de Luxembourg, Luxembourg.
Dig Liver Dis. 2011 Nov;43(11):899-904. doi: 10.1016/j.dld.2011.05.020. Epub 2011 Aug 9.
BACKGROUND/AIMS: Colonoscopy has been proven a valuable tool in preventing colorectal cancer in controlled studies; we conducted a longitudinal confirmation study in everyday clinical practice.
In a retrospective study, we monitored the outcome of patients with a total colonoscopy at our hospital between 1994 and 2007. We analysed the data of in-house follow-up colonoscopies, a national person registry and the morphological tumour registry centralizing all histopathological data at a national level. Patients with a particular colorectal cancer risk were excluded.
8950 patients were included in our study. 2032 (22.7%) patients had at least one colorectal adenoma at index colonoscopy. Adenoma prevalence was significantly higher in men than in women (27.9% vs. 17.4%, p<0.001) and was increasing with age in both sexes. Patients were followed for a mean of 5.2 years and 19 had invasive colorectal cancer detected over 47,725 person years of follow-up. The incidence rate was 0.40 cases/1000 person years of follow-up (95% confidence interval, 0.25-0.62), and the standardized incidence ratio was 0.37 (95% confidence interval, 0.24-0.58).
Incidence rates of colorectal cancer are low in the follow-up of patients having undergone a total colonoscopy in everyday practice. After standard therapy of colorectal adenomas at colonoscopy, there is little evidence for excess colorectal cancer incidence in this subgroup.
背景/目的：在对照研究中，结肠镜检查已被证明是预防结直肠癌的有效工具；我们在日常临床实践中进行了一项纵向确认研究。
在一项回顾性研究中，我们监测了 1994 年至 2007 年期间在我院进行全结肠镜检查的患者的结果。我们分析了内部随访结肠镜检查、国家人员登记处和集中所有组织病理学数据的国家形态肿瘤登记处的数据。排除有特定结直肠癌风险的患者。
我们的研究纳入了 8950 名患者。2032 名（22.7%）患者在索引结肠镜检查中至少有一个结直肠腺瘤。男性腺瘤患病率明显高于女性（27.9%比 17.4%，p<0.001），且在两性中均随年龄增长而增加。患者平均随访 5.2 年，在 47725 人年的随访中有 19 例侵袭性结直肠癌被检出。发病率为 0.40 例/1000 人年随访（95%置信区间，0.25-0.62），标准化发病率比为 0.37（95%置信区间，0.24-0.58）。
在日常实践中对全结肠镜检查患者进行随访时，结直肠癌的发病率较低。在结肠镜检查对结直肠腺瘤进行标准治疗后，该亚组的结直肠癌发病率几乎没有证据增加。
