Portillo Isabel, Arana-Arri Eunate, Idigoras Isabel, Bilbao Isabel, Martínez-Indart Lorea, Bujanda Luis, Gutierrez-Ibarluzea Iñaki
Isabel Portillo, Eunate Arana-Arri, Isabel Idigoras, Isabel Bilbao, Lorea Martínez-Indart, BioCruces Health Research Institute, Plaza de Cruces, 48903 Barakaldo, Spain.
World J Gastroenterol. 2017 Apr 21;23(15):2731-2742. doi: 10.3748/wjg.v23.i15.2731.
To assess proportions, related conditions and survival of interval cancer (IC).
The programme has a linkage with different clinical databases and cancer registers to allow suitable evaluation. This evaluation involves the detection of ICs after a negative faecal inmunochemical test (FIT), interval cancer FIT (IC-FIT) prior to a subsequent invitation, and the detection of ICs after a positive FIT and confirmatory diagnosis without colorectal cancer (CRC) detected and before the following recommended colonoscopy, IC-colonoscopy. We conducted a retrospective observational study analyzing from January 2009 to December 2015 1193602 invited people onto the Programme (participation rate of 68.6%).
Two thousand five hundred and eighteen cancers were diagnosed through the programme, 18 cases of IC-colonoscopy were found before the recommended follow-up (43542 colonoscopies performed) and 186 IC-FIT were identified before the following invitation of the 769200 negative FITs. There was no statistically significant relation between the predictor variables of ICs with sex, age and deprivation index, but there was relation between location and stage. Additionally, it was observed that there was less risk when the location was distal rather than proximal (OR = 0.28, 95%CI: 0.20-0.40, < 0.0001), with no statistical significance when the location was in the rectum as opposed to proximal. When comparing the screen-detected cancers (SCs) with ICs, significant differences in survival were found ( < 0.001); being the 5-years survival for SCs 91.6% and IC-FIT 77.8%.
These findings in a Population Based CRC Screening Programme indicate the need of population-based studies that continue analyzing related factors to improve their detection and reducing harm.
评估间期癌（IC）的比例、相关情况及生存率。
该项目与不同的临床数据库和癌症登记处建立了联系，以便进行适当评估。这种评估包括在粪便免疫化学检测（FIT）呈阴性后检测间期癌，在后续邀请之前检测间期癌FIT（IC-FIT），以及在FIT呈阳性且确诊无结直肠癌（CRC）后、在接下来推荐的结肠镜检查之前检测间期癌，即IC-结肠镜检查。我们进行了一项回顾性观察研究，分析了2009年1月至2015年12月期间受邀参加该项目的1193602人（参与率为68.6%）。
通过该项目诊断出2518例癌症，在推荐的随访之前发现18例IC-结肠镜检查病例（共进行了43542次结肠镜检查），在769200次阴性FIT后的后续邀请之前识别出186例IC-FIT。间期癌的预测变量与性别、年龄和贫困指数之间无统计学显著关系，但与部位和分期有关。此外，观察到部位为远端时风险低于近端（比值比=0.28，95%置信区间：0.20-0.40，P<0.0001），部位为直肠与近端相比无统计学显著差异。将筛查发现的癌症（SCs）与间期癌进行比较时，发现生存率存在显著差异（P<0.001）；SCs的5年生存率为91.6%，IC-FIT为77.8%。
基于人群的结直肠癌筛查项目中的这些发现表明，需要进行基于人群的研究，持续分析相关因素以改善其检测并减少危害。
