Elferink M A G, Toes-Zoutendijk E, Vink G R, Lansdorp-Vogelaar I, Meijer G A, Dekker E, Lemmens V E P P
Integraal Kankercentrum Nederland, Utrecht.
Ned Tijdschr Geneeskd. 2018;162:D2283.
To describe the effect of population screening for colorectal carcinoma (CRC) with the faecal immunochemical test, introduced in 2014, on the incidence of CRC in the Netherlands and to analyse differences between patient and tumour characteristics, stage distribution and treatment of carcinomas that were screening-detected and were not detected by screening (non-screening-detected).
Retrospective observational study.
We analysed data from the Netherlands Cancer Registry. We selected all CRCs diagnosed in the 2010-2016 period and calculated incidence rates standardised for the European population. For comparison between screening-detected and non-screening-detected carcinomas, we selected all CRCs diagnosed in 2015.
The number of newly diagnosed CRCs rose from 13,028 in 2013 to 15,185 in 2014 and to 15,807 in 2015. This increase could only be seen for the birth years of people who had been invited for population screening during that particular year. The percentage of men was higher for screening-detected carcinomas than for non-screening-detected carcinomas (62% vs 55%). Screening-detected carcinomas were also more often in the left side of the colon (76% vs 64%). The percentage of patients with stage I CRC was higher in the group with screening-detected carcinomas (48% vs 16%). Patients with screening-detected carcinomas more often underwent local treatment or only resection without adjuvant or neoadjuvant treatment than the patients with non-screening-detected carcinomas.
During the first years after the introduction of population screening, the incidence of CRC has increased as the result of earlier detection. Screening-detected carcinomas have a more favourable stage distribution and these patients are undergoing less-invasive treatment more often.
描述2014年引入的粪便免疫化学检测用于结直肠癌(CRC)人群筛查对荷兰CRC发病率的影响,并分析筛查发现的癌和未通过筛查发现的癌(非筛查发现)在患者和肿瘤特征、分期分布及治疗方面的差异。
回顾性观察研究。
我们分析了荷兰癌症登记处的数据。我们选取了2010 - 2016年期间诊断的所有CRC病例,并计算了欧洲人群标准化发病率。为比较筛查发现的癌和非筛查发现的癌,我们选取了2015年诊断的所有CRC病例。
新诊断CRC病例数从2013年的13,028例增至2014年的15,185例,再增至2015年的15,807例。这种增加仅在特定年份被邀请进行人群筛查的出生年份人群中可见。筛查发现的癌中男性比例高于非筛查发现的癌(62%对55%)。筛查发现的癌也更常位于结肠左侧(76%对64%)。筛查发现的癌患者中I期CRC患者的比例更高(48%对16%)。与非筛查发现的癌患者相比,筛查发现的癌患者更常接受局部治疗或仅行切除术而不进行辅助或新辅助治疗。
在引入人群筛查后的头几年,由于早期发现,CRC发病率有所增加。筛查发现的癌具有更有利的分期分布,且这些患者更常接受侵入性较小的治疗。