Quality Assurance Working Group, Austrian Society for Gastroenterology and Hepatology, Vienna, Austria.
JAMA. 2011 Sep 28;306(12):1352-8. doi: 10.1001/jama.2011.1362.
Although some studies have shown that men are at greater age-specific risk for advanced colorectal neoplasia than women, the age for referring patients to screening colonoscopy is independent of sex and usually recommended to be 50 years.
To determine and compare the prevalence and number needed to screen (NNS) for adenomas, advanced adenomas (AAs), and colorectal carcinomas (CRCs) for different age groups in men and women.
DESIGN, SETTING, AND PATIENTS: Cohort study of 44,350 participants in a national screening colonoscopy program over a 4-year period (2007 to 2010) in Austria.
Prevalence and NNS of adenomas, AAs, and CRCs in different age groups for men and women.
The median ages were 60.7 years (interquartile range [IQR], 54.5-67.5 years) for women and 60.6 years (IQR, 54.3-67.6 years) for men, and the sex ratio was nearly identical (51.0% [22,598] vs 49.0% [21,572]). Adenomas were found in 19.7% of individuals screened (95% CI, 19.3%-20.1%; n = 8743), AAs in 6.3% (95% CI, 6.1%-6.5%; n = 2781), and CRCs in 1.1% (95% CI, 1.0%-1.2%; n = 491); NNS were 5.1 (95% CI, 5.0-5.2), 15.9 (95% CI, 15.4-16.5), and 90.9 (95% CI, 83.3-100.0), respectively. Male sex was significantly associated with a higher prevalence of adenomas (24.9% [95% CI, 24.3%-25.4%] vs 14.8% [95% CI, 14.3%-15.2%]; P < .001; unadjusted odds ratio [OR], 1.9 [95% CI, 1.8-2.0]), AAs (8.0% [95% CI, 7.6%-8.3%] vs 4.7% [95% CI, 4.4%-4.9%]; P < .001; unadjusted OR, 1.8 [95% CI, 1.6-1.9]), and CRCs (1.5% [95% CI, 1.3%-1.7%] vs 0.7% [95% CI, 0.6%-0.9%]; P < .001; unadjusted OR, 2.1 [95% CI, 1.7-2.5]). The prevalence of AAs in 50- to 54-year-old individuals was 5.0% (95% CI, 4.4%-5.6%) in men but 2.9% (95% CI, 2.5%-3.4%) in women (adjusted P = .001); the NNS in men was 20 (95% CI, 17.8-22.6) vs 34 in women (95% CI, 29.1-40; adjusted P = .001). There was no statistical significance between the prevalence and NNS of AAs in men aged 45 to 49 years compared with women aged 55 to 59 years (3.8% [95% CI, 2.3%-6.1%] vs 3.9% [95% CI, 3.3%-4.5%] and 26.1 [95% CI, 16.5-44.4] vs 26 [95% CI, 22.5-30.2]; P = .99).
Among a cohort of Austrian individuals undergoing screening colonoscopy, the prevalence and NNS of AAs were comparable between men aged 45 to 49 years and women aged 55 to 59 years.
虽然一些研究表明，男性比女性在特定年龄段患晚期结直肠腺瘤的风险更高，但将患者转介至筛查结肠镜检查的年龄与性别无关，通常建议为 50 岁。
确定并比较男性和女性不同年龄组中腺瘤、高级腺瘤（AA）和结直肠癌（CRC）的患病率和所需筛查人数（NNS）。
设计、地点和患者：对在奥地利进行的一项为期 4 年（2007 年至 2010 年）的全国筛查结肠镜检查计划中的 44350 名参与者进行的队列研究。
不同年龄组中男性和女性的腺瘤、AA 和 CRC 的患病率和 NNS。
女性的中位年龄为 60.7 岁（四分位间距[IQR]，54.5-67.5 岁），男性为 60.6 岁（IQR，54.3-67.6 岁），性别比例几乎相同（51.0%[22598]与 49.0%[21572]）。筛查人群中发现腺瘤的比例为 19.7%（95%CI，19.3%-20.1%；n=8743），高级腺瘤的比例为 6.3%（95%CI，6.1%-6.5%；n=2781），结直肠癌的比例为 1.1%（95%CI，1.0%-1.2%；n=491）；NNS 分别为 5.1（95%CI，5.0-5.2）、15.9（95%CI，15.4-16.5）和 90.9（95%CI，83.3-100.0）。男性的性别与腺瘤（24.9%[95%CI，24.3%-25.4%]比 14.8%[95%CI，14.3%-15.2%]；P<0.001；未调整的优势比[OR]，1.9[95%CI，1.8-2.0]）、AA（8.0%[95%CI，7.6%-8.3%]比 4.7%[95%CI，4.4%-4.9%]；P<0.001；未调整的 OR，1.8[95%CI，1.6-1.9]）和 CRC（1.5%[95%CI，1.3%-1.7%]比 0.7%[95%CI，0.6%-0.9%]；P<0.001；未调整的 OR，2.1[95%CI，1.7-2.5]）的患病率显著相关。50-54 岁男性 AA 的患病率为 5.0%（95%CI，4.4%-5.6%），而女性为 2.9%（95%CI，2.5%-3.4%）（调整后的 P=0.001）；男性的 NNS 为 20（95%CI，17.8-22.6），女性为 34（95%CI，29.1-40；调整后的 P=0.001）。与 45-49 岁男性相比，55-59 岁女性的 AA 患病率和 NNS 无统计学意义（3.8%[95%CI，2.3%-6.1%]比 3.9%[95%CI，3.3%-4.5%]和 26.1[95%CI，16.5-44.4]比 26[95%CI，22.5-30.2]；P=0.99）。
在奥地利进行的一项筛查结肠镜检查队列研究中，45-49 岁男性与 55-59 岁女性的 AA 患病率和 NNS 相当。
