Audibert Céline, Perlaky Anna, Glass Daniel
Deerfield Institute, Epalinges, Switzerland.
Deerfield Institute, New York, NY, USA.
Contemp Clin Trials Commun. 2017 Jun 24;7:116-121. doi: 10.1016/j.conctc.2017.06.008. eCollection 2017 Sep.
To examine colorectal cancer screening practices among colonoscopy specialists from 5 countries and inform public health needs in improvement of the ongoing global crisis in colorectal cancer.
An online survey among colonoscopy specialists was conducted in France, Germany, the United Kingdom, Japan, and the United States. The survey covered topics on colonoscopy practices in the screening as well as in the treatment setting, as well as expected trends.
Participating colonoscopy specialists included 114 physicians from the United States, 81 from France, 80 from Germany, 80 from the United Kingdom, and 156 from Japan. Survey results revealed that 59%-73% of colonoscopies were performed in patients aged 50-75 years old, with 15%-23% performed in patients <50 years old. The proportion of patients with age-based versus symptom-based first colorectal cancer screening varied by country and age. Sedation protocols varied by country; however, rate of incomplete colonoscopy was low in all countries. The proportion of negative first colonoscopies decreased with age in all countries.
This multi-country survey of real-world clinical practices suggests a need for improved participation in population age-based colorectal cancer screening and possibly younger age of screening initiation than currently recommended by guidelines. The variation among countries in the proportion of patients who received their first colonoscopy due to age-based colorectal cancer screening versus symptom-based initial colonoscopy indicates that population-based screening initiatives and improved health outcomes will benefit from public health awareness programs.
调查5个国家结肠镜检查专家的结直肠癌筛查实践情况，并为改善当前全球结直肠癌危机中的公共卫生需求提供信息。
在法国、德国、英国、日本和美国对结肠镜检查专家进行了一项在线调查。该调查涵盖了筛查以及治疗环境中结肠镜检查实践的相关主题，以及预期趋势。
参与调查的结肠镜检查专家包括来自美国的114名医生、来自法国的81名、来自德国的80名、来自英国的80名以及来自日本的156名。调查结果显示，59%-73%的结肠镜检查是在50-75岁的患者中进行的，15%-23%是在50岁以下的患者中进行的。基于年龄与基于症状的首次结直肠癌筛查患者比例因国家和年龄而异。镇静方案因国家而异；然而，所有国家的结肠镜检查不完全率都很低。所有国家中首次结肠镜检查结果为阴性的比例均随年龄下降。
这项对现实世界临床实践的多国调查表明，需要提高基于人群年龄的结直肠癌筛查参与度，并且可能需要比目前指南建议的更早开始筛查。因基于年龄的结直肠癌筛查与基于症状的首次结肠镜检查而接受首次结肠镜检查的患者比例在不同国家之间存在差异，这表明基于人群的筛查倡议和改善健康结果将受益于公共卫生意识项目。
