肠易激综合征与结直肠肿瘤的发病率：一项针对台湾社区筛查人群的前瞻性队列研究
Irritable bowel syndrome and the incidence of colorectal neoplasia: a prospective cohort study with community-based screened population in Taiwan.
作者信息
Chang H-C, Yen A M-F, Fann J C-Y, Chiu S Y-H, Liao C-S, Chen H-H, Yang K-C, Chen L-S, Lin Y-M
机构信息
1] Division of Gastroenterology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan [2] School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
出版信息
Br J Cancer. 2015 Jan 6;112(1):171-6. doi: 10.1038/bjc.2014.575. Epub 2014 Dec 4.
BACKGROUND
We aim to report the prevalence of irritable bowel syndrome (IBS) and elucidate the influence of IBS on the incidence of colorectal neoplasm through a community-screening-based, longitudinal follow-up study.
METHODS
We enroled 39,384 community residents aged 40 years or older who had participated in a community-based colorectal cancer-screening programme with an immunochemical faecal occult test since 1999. We followed a cohort that was free of colorectal neoplasm (excluding colorectal neoplasm at baseline) to ascertain the incident colorectal neoplasm through each round of screening and used a nationwide cancer registry. Information on IBS was obtained by linking this screened cohort with population-based health insurance claim data. Other confounding factors were also collected via questionnaire or biochemical tests.
RESULTS
The overall period prevalence of IBS was 23%, increasing from 14.7% for subjects aged 40-49 years to 43.7% for those aged 70 years and more. After controlling for age, gender and family history of colorectal cancer, screenees who had been diagnosed as having IBS exhibited a significantly elevated level (21%; adjusted hazard ratio (HR)=1.21 (95% CI: 1.02-1.42)) of incident colorectal adenoma compared with those who had not been diagnosed with IBS. A similar finding was noted for invasive carcinoma; however, the size of the effect was of borderline statistical significance (adjusted HR=1.20 (95% CI: 0.94-1.53)).
CONCLUSIONS
IBS led to an increased risk for incident colorectal neoplasm.
背景
我们旨在通过一项基于社区筛查的纵向随访研究，报告肠易激综合征（IBS）的患病率，并阐明IBS对结直肠肿瘤发病率的影响。
方法
我们纳入了39384名40岁及以上的社区居民，这些居民自1999年以来参加了基于社区的结直肠癌筛查项目，采用免疫化学粪便潜血试验。我们追踪了一个无结直肠肿瘤（排除基线时的结直肠肿瘤）的队列，通过每一轮筛查确定结直肠肿瘤的发病情况，并使用全国癌症登记处的数据。通过将这个筛查队列与基于人群的健康保险理赔数据相链接，获取IBS的信息。其他混杂因素也通过问卷调查或生化检测收集。
结果
IBS的总体期间患病率为23%，从40-49岁受试者的14.7%增加到70岁及以上受试者的43.7%。在控制年龄、性别和结直肠癌家族史后，被诊断为IBS的筛查者与未被诊断为IBS的筛查者相比，结直肠腺瘤的发病水平显著升高（21%；调整后风险比（HR）=1.21（95%CI：1.02-1.42））。侵袭性癌也有类似发现；然而，效应大小具有临界统计学意义（调整后HR=1.20（95%CI：0.94-1.53））。
结论
IBS导致结直肠肿瘤发病风险增加。
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