9571Public Health Scotland, Edinburgh, Scotland, UK.
Centre for Research into Cancer Prevention and Screening, 85326University of Dundee, Dundee, Scotland, UK.
J Med Screen. 2022 Mar;29(1):26-31. doi: 10.1177/09691413211056970. Epub 2021 Nov 22.
There is evidence that colorectal cancer screening using faecal haemoglobin is less effective in women than men. The faecal haemoglobin concentrations were therefore examined in women and men with screen-detected colorectal cancer.
Scottish Bowel Screening Programme, following the introduction of a faecal immunochemical test from November 2017, to March 2020
Data were collated on faecal haemoglobin concentrations, pathological stage and anatomical site of the main lesion in participants who had colorectal cancer detected. The data in women and men were compared.
For the faecal haemoglobin concentrations studied (80 µg Hb/g faeces), the distributions indicated lower concentrations in women. Marked differences were found between women and men diagnosed with colorectal cancer. The median faecal haemoglobin concentration for women ( = 720) was 408 µg Hb/g faeces compared to 473 µg Hb/g faeces for men ( = 959) ( = 0.004) and 50.6% of the results were 400 µg Hb/g faeces in women; in men, this was 57.8%. The difference in faecal haemoglobin concentrations in women and men became less statistically significant as stage advanced from stages I-IV. For right-sided, left-sided and rectal colorectal cancer, a similar gender difference persisted in all sites. Differences in faecal haemoglobin between the genders were significant for left-sided cancers and stage I and approached significance for rectal cancers and stage II, but all sites and stages showed lower median faecal haemoglobin concentrations for women.
To minimise gender inequalities, faecal immunochemical test-based colorectal cancer screening programmes should evaluate a strategy of using different faecal haemoglobin concentration thresholds in women and men.
有证据表明，粪便血红蛋白检测在女性中的结直肠癌筛查效果不如男性。因此，对通过筛查发现的结直肠癌患者的粪便血红蛋白浓度进行了检测。
苏格兰结直肠筛查计划，在 2017 年 11 月引入粪便免疫化学检测后，到 2020 年 3 月。
收集了粪便血红蛋白浓度、病变的病理分期和主要病变的解剖部位的数据，这些数据来自通过筛查发现的结直肠癌患者。对女性和男性的数据进行了比较。
在研究的粪便血红蛋白浓度（80μg Hb/g 粪便）中，女性的分布表明浓度较低。在诊断为结直肠癌的女性和男性之间发现了显著差异。女性（中位数=720）的粪便血红蛋白浓度中位数为 408μg Hb/g 粪便，而男性（中位数=959）为 473μg Hb/g 粪便（=0.004），并且女性 50.6%的结果为 400μg Hb/g 粪便；在男性中，这一比例为 57.8%。随着从 I-IV 期进展，女性和男性的粪便血红蛋白浓度差异在统计学上变得不那么显著。对于右侧、左侧和直肠结直肠癌，所有部位均存在相似的性别差异。在性别之间，左半结肠癌和 I 期结肠癌的粪便血红蛋白差异具有统计学意义，而直肠癌和 II 期结肠癌的粪便血红蛋白差异接近统计学意义，但所有部位和所有分期的女性粪便血红蛋白浓度中位数均较低。
为了最大限度地减少性别不平等，粪便免疫化学检测为基础的结直肠癌筛查计划应评估在女性和男性中使用不同粪便血红蛋白浓度阈值的策略。
