Okada Takuya, Tanaka Koji, Kawachi Hiroshi, Ito Takashi, Nishikage Tetsuro, Odagaki Tomoyuki, Zárate Alejandro J, Kronberg Udo, López-Köstner Francisco, Karelovic Stanko, Flores Sergio, Estela Ricardo, Tsubaki Masahiro, Uetake Hiroyuki, Eishi Yoshinobu, Kawano Tatsuyuki
Latin American Collaborative Research Center of Tokyo Medical and Dental University, Santiago, Chile.
Department of Digestive and General Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Cancer. 2016 Jan 1;122(1):71-7. doi: 10.1002/cncr.29715. Epub 2015 Oct 7.
In Chile, mortality from colorectal cancer (CRC) has increased rapidly. To help address this issue, the Prevention Project for Neoplasia of the Colon and Rectum (PRENEC) program was initiated in 2012 with intensive support from Tokyo Medical and Dental University (TMDU) in Tokyo, Japan, as part of an international collaboration.
From June 2012 to July 2014, a total of 10,575 asymptomatic participants were enrolled in PRENEC. Participants with positive immunochemical fecal occult blood test (iFOBT) results or a family history of CRC underwent colonoscopy. The colonoscopy results from a similar, previous project in Chile (PREVICOLON) were compared with those from PRENEC. Furthermore, the initial colonoscopies of 1562 participants in PRENEC were analyzed according to whether the colonoscopists were from TMDU or Chile.
The complete colonoscopy, adenoma detection, and cancer detection rates were 88.0%, 26.7%, and 1.1%, respectively, in PREVICOLON, while the corresponding values were 94.4%, 41.8%, and 6.0%, respectively, in PRENEC. In PRENEC, 107 cases of CRC were detected, amounting for 1.0% of all participants. Considering initial colonoscopies in PRENEC, the complete colonoscopy, adenoma detection, and cancer detection rates were 97.4%, 45.3%, and 9.3%, respectively, for physicians at TMDU and 93.3%, 41.5%, and 5.1%, respectively for Chilean physicians. The detection rates of intramucosal cancer were 7.3% and 3.7%, respectively, for TMDU and Chilean physicians.
Quality indicators of colonoscopy substantially improved from PREVICOLON to PRENEC. The assessments made by Chilean physicians alone were improved in PRENEC, but remained better in the TMDU group. Moreover, physicians from TMDU detected more CRCs than Chilean physicians, especially at earlier stages.
在智利，结直肠癌（CRC）死亡率迅速上升。为帮助解决这一问题，2012年启动了结肠直肠癌瘤形成预防项目（PRENEC），作为国际合作的一部分，该项目在日本东京的东京医科齿科大学（TMDU）的大力支持下开展。
2012年6月至2014年7月，共有10575名无症状参与者纳入PRENEC。免疫化学粪便潜血试验（iFOBT）结果呈阳性或有CRC家族史的参与者接受结肠镜检查。将智利之前一个类似项目（PREVICOLON）的结肠镜检查结果与PRENEC的结果进行比较。此外，根据结肠镜检查医生是来自TMDU还是智利，对PRENEC中1562名参与者的初次结肠镜检查进行分析。
在PREVICOLON中，全结肠镜检查、腺瘤检出率和癌症检出率分别为88.0%、26.7%和1.1%，而在PRENEC中，相应值分别为94.4%、41.8%和6.0%。在PRENEC中，检测到107例CRC，占所有参与者的1.0%。考虑到PRENEC中的初次结肠镜检查，TMDU医生的全结肠镜检查、腺瘤检出率和癌症检出率分别为97.4%、45.3%和9.3%，智利医生分别为93.3%、41.5%和5.1%。TMDU和智利医生的黏膜内癌检出率分别为7.3%和3.7%。
从PREVICOLON到PRENEC，结肠镜检查的质量指标有了显著改善。仅智利医生的评估在PRENEC中有所改善，但在TMDU组中仍然更好。此外，TMDU的医生比智利医生检测到更多的CRC，尤其是在早期阶段。
