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一站式多癌种筛查:综合癌症预防中心的经验。

One stop screening for multiple cancers: the experience of an integrated cancer prevention center.

机构信息

The Integrated Cancer Prevention Center, Tel-Aviv Sourasky Medical Center/Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Eur J Intern Med. 2013 Apr;24(3):245-9. doi: 10.1016/j.ejim.2012.12.012. Epub 2013 Jan 9.

Abstract

BACKGROUND

Cancer is a leading cause of mortality worldwide. Screening is a key strategy for reducing cancer morbidity and mortality.

METHODS

We aimed to describe the experience of an integrated cancer prevention center in screening an asymptomatic population for the presence of neoplasia. One-thousand consecutive asymptomatic, apparently healthy adults, aged 20-80 years, were screened for early detection of 11 common cancers that account for 70-80% of cancer mortality.

RESULTS

Malignant and benign lesions were found in 2.4% and 7.1% of the screenees, respectively. The most common malignant lesions were in the gastrointestinal tract and breast followed by gynecological and skin. The compliance rate for the different screening procedures was considerably higher than the actual screening rate in the general Israeli population - 78% compared to 60% for mammography (p<0.001) and 39% compared to 16% for colonoscopy (p<0.001). Advanced age, family history of cancer and certain lifestyle parameters were associated with increased risk. Moreover, polymorphisms in the APC and CD24 genes indicated high cancer risk. When two of the polymorphisms existed in an individual, the risk for a neoplastic lesion was extremely high (OR 2.3 [95% CI 0.94-5.9]).

CONCLUSIONS

One stop shop screening for 11 common cancers in the setting of a multidisciplinary outpatient clinic is feasible and can detect cancer at an early stage.

摘要

背景

癌症是全球主要死因之一。筛查是降低癌症发病率和死亡率的关键策略。

方法

我们旨在描述一个综合癌症预防中心在为无症状人群筛查肿瘤方面的经验。对 1000 名无症状、明显健康的 20-80 岁成年人进行筛查,以早期发现占癌症死亡率 70-80%的 11 种常见癌症。

结果

恶性和良性病变分别在 2.4%和 7.1%的筛查者中发现。最常见的恶性病变发生在胃肠道和乳房,其次是妇科和皮肤。不同筛查程序的依从率明显高于普通以色列人群的实际筛查率-与乳房 X 光检查相比,为 78%比 60%(p<0.001),与结肠镜检查相比,为 39%比 16%(p<0.001)。年龄较大、癌症家族史和某些生活方式参数与风险增加有关。此外,APC 和 CD24 基因的多态性表明存在高癌症风险。当个体存在两种多态性时,肿瘤病变的风险极高(OR 2.3[95%CI 0.94-5.9])。

结论

在多学科门诊环境下对 11 种常见癌症进行一站式筛查是可行的,可以早期发现癌症。

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