在肠癌筛查计划中，筛查检出的结直肠癌与间隔期结直肠癌的比较。
Comparison of screen-detected and interval colorectal cancers in the Bowel Cancer Screening Programme.
机构信息
Northern Colorectal Cancer Audit Group, Northumbria Health Care Trust, Northumberland, UK.
出版信息
Br J Cancer. 2012 Jul 24;107(3):417-21. doi: 10.1038/bjc.2012.305. Epub 2012 Jul 10.
BACKGROUND
The NHS Bowel Cancer Screening Programme (BCSP) offers biennial faecal occult blood testing (FOBt) followed by colonoscopy after positive results. Colorectal cancers (CRCs) registered with the Northern Colorectal Cancer Audit Group database were cross-referenced with the BCSP database to analyse their screening history.
METHODS
The CRCs in the screening population between April 2007 and March 2010 were identified and classified into four groups: control (diagnosed before first screening invite), screen-detected, interval (diagnosed between screening rounds after a negative FOBt), and non-uptake (declined screening). Patient demographics, tumour characteristics and survival were compared between groups.
RESULTS
In all, 511 out of 1336 (38.2%) CRCs were controls; 825 (61.8%) were in individuals invited for screening of which 322 (39.0%) were screen detected, 311 (37.7%) were in the non-uptake group, and 192 (23.3%) were interval cancers. Compared with the control and interval cancer group, the screen-detected group had a higher proportion of men (P=0.002, P=0.003 respectively), left colon tumours (P=0.007, P=0.003), and superior survival (both P<0.001). There was no difference in demographics, tumour location/stage, or survival between control and interval groups.
CONCLUSION
The FOBt is better at detecting cancers in the left colon and in men. The significant numbers of interval cancers weren't found to have an improved outcome compared with the non-screened population.
背景
英国国民保健制度（NHS）肠癌筛查计划（BCSP）提供每两年一次的粪便潜血检测（FOBt），阳性结果后进行结肠镜检查。将在北方结直肠癌审计组数据库中登记的结直肠癌与 BCSP 数据库进行交叉参考，以分析其筛查史。
方法
在 2007 年 4 月至 2010 年 3 月期间，确定筛查人群中的 CRC，并将其分为四组：对照组（首次筛查邀请前诊断）、筛查发现组、间隔组（阴性 FOBt 后两轮筛查之间诊断）和未接受筛查组（拒绝筛查）。比较组间患者的人口统计学特征、肿瘤特征和生存情况。
结果
在所有 CRC 中，有 511 例（38.2%）为对照组；825 例（61.8%）为受邀筛查人群，其中 322 例（39.0%）为筛查发现组，311 例（37.7%）为未接受筛查组，192 例（23.3%）为间隔癌组。与对照组和间隔癌组相比，筛查发现组中男性比例更高（P=0.002，P=0.003），左半结肠癌比例更高（P=0.007，P=0.003），生存更好（均 P<0.001）。对照组和间隔癌组之间在人口统计学特征、肿瘤部位/分期或生存方面没有差异。
结论
FOBt 更能检测左半结肠癌和男性的癌症。与未筛查人群相比，间隔癌组的比例没有显著增加，预后也没有改善。
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