Álvarez-Delgado A, García M L Pérez, García-González J M, de Sena H Iglesias, Chamorro A J, Gómez M F Lorenzo, Marcos M, Mirón-Canelo J A
Digestive, Department of Medicine, University Hospital of Salamanca-IBSAL, University of Salamanca, 37007 Salamanca, Spain.
Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
J Clin Med. 2021 Oct 29;10(21):5072. doi: 10.3390/jcm10215072.
The general objective of this research is to improve the quality of colorectal cancer screening (CRC) by assessing, as an indicator of effectiveness, the ability of colonoscopy to detect more advanced adenomas in the exposed group than in the control group.
The present work is designed as an open-label randomized study on cancer screening, using two groups based on their exposure to the protocol: an exposed to intervention group (EIG, 167), and a control group (CG, 167), without the intervention of the protocol and by 1:1 matching.
In 167 patients in the GEI, 449 polyps are visualized and 274 are adenomas (80.58%), of which 100 (36.49%) are advanced adenomas. In the CG ( = 174), there are 321 polyps and 152 adenomas (82.60%). The variables significantly associated by logistic regression to the detection of adenomas are the male sex with an OR of 2.52. The variable time to withdrawal, ≥9 min, is significant at 99% confidence ( = 0.002/OR 34.67) and the fractional dose is significant at 99% ( = 0.009, OR 7.81).
Based on the observations made, our study suggests that the intervention in collaboration between primary care and hospital care is effective from a preventive point of view and achieves the objective of effectiveness and quality of the PCCR.
本研究的总体目标是通过评估结肠镜检查在暴露组中比对照组检测出更多进展期腺瘤的能力，以此作为有效性指标，来提高结直肠癌筛查（CRC）的质量。
本研究设计为一项关于癌症筛查的开放标签随机研究，根据两组对方案的暴露情况进行分组：暴露于干预组（EIG，167例）和对照组（CG，167例），对照组不接受方案干预，两组按1:1匹配。
在EIG组的167例患者中，可见449个息肉，其中274个为腺瘤（80.58%），其中100个（36.49%）为进展期腺瘤。在CG组（n = 174）中，有321个息肉和152个腺瘤（82.60%）。经逻辑回归分析，与腺瘤检测显著相关的变量为男性，比值比为2.52。退镜时间变量≥9分钟，在99%置信度下具有显著性（P = 0.002/OR 34.67），分次剂量在99%置信度下具有显著性（P = 0.009，OR 7.81）。
基于观察结果，我们的研究表明，从预防角度来看，初级保健与医院护理之间的合作干预是有效的，并且实现了初级保健结直肠癌筛查的有效性和质量目标。
