越南 103542 例人群的首次结直肠癌筛查结果，以及对亚太地区结直肠癌筛查计划的系统评价。
Findings from the first colorectal cancer screening among 103 542 individuals in Vietnam with systematic review of colorectal cancer screening programs in Asia-Pacific region.
机构信息
Vietnam Colorectal Cancer and Polyps Research Program, Vinmec Healthcare System, Hanoi, Vietnam.
College of Health Sciences, VinUniversity (VinUni), Hanoi, Vietnam.
出版信息
Jpn J Clin Oncol. 2022 Jul 8;52(7):707-715. doi: 10.1093/jjco/hyac043.
BACKGROUND
Colorectal cancer is a leading cancer incidence and cause of death worldwide and in Vietnam. Although screening is considered an effective measure to prevent and control colorectal cancer, there is no such effort in Vietnam.
METHODS
Between 01 January 2018 and 31 October 2019, a population-based colorectal cancer screening program was conducted in Hanoi, Vietnam. A health advocacy campaign and follow-up phone calls were used to enroll residents aged ≥40 years old to complete an immunochemical-fecal occult blood testing. Positive immunochemical-fecal occult blood testing was followed by a colonoscopy. We also conducted a systematic review of the colorectal cancer screening programs in the Asia-Pacific region that used similar approach by searching Ovid Medline and PubMed databases.
RESULTS
During study period, 103 542 individuals among 672 742 eligible residents attended the screening of whom 81.5% participants finished immunochemical-fecal occult blood testing test and the positive rate was 6.1%. The coverage rate for immunochemical-fecal occult blood testing test was 11.9%. Among 2278 individuals who underwent colonoscopy, 3.5% were histologically diagnosed with cancer, 17.8% with advanced adenomas, and 23.1% with non-advanced adenomas. Males had significantly higher detection rate of advanced adenomas, cancer or ≥ two polyps/tumor than females (P < 0.0001). The systematic review showed that in two-step modality (i.e. immunochemical-fecal occult blood testing/fecal immunochemical test and colonoscopy), the test positive was from 4.1 to 10.6%. Once colonoscopy was performed subsequently, the rate of cancer among positive participants was from 1.7 to 16.4% and that of advanced adenomas was from 7.1 to 23.1%.
CONCLUSION
We showed that the two-step modality is a promising strategy for colorectal cancer screening in Vietnam that might apply to similar settings with limited resources.
背景
结直肠癌是全球和越南发病率和死亡率最高的癌症之一。尽管筛查被认为是预防和控制结直肠癌的有效措施，但越南尚未开展此类工作。
方法
2018 年 1 月 1 日至 2019 年 10 月 31 日，越南河内开展了一项基于人群的结直肠癌筛查计划。通过健康宣传运动和后续电话联系，招募年龄≥40 岁的居民完成免疫化学粪便隐血检测。免疫化学粪便隐血检测阳性者行结肠镜检查。我们还通过检索 Ovid Medline 和 PubMed 数据库，对亚太地区使用类似方法的结直肠癌筛查计划进行了系统评价。
结果
在研究期间，在 672742 名符合条件的居民中，有 103542 人参加了筛查，其中 81.5%的参与者完成了免疫化学粪便隐血检测，阳性率为 6.1%。免疫化学粪便隐血检测的覆盖率为 11.9%。在 2278 名接受结肠镜检查的患者中，有 3.5%的患者组织学诊断为癌症，17.8%的患者诊断为高级腺瘤，23.1%的患者诊断为非高级腺瘤。男性高级腺瘤、癌症或≥2 个息肉/肿瘤的检出率明显高于女性（P<0.0001）。系统评价显示，在两步法（即免疫化学粪便隐血检测/粪便免疫化学检测和结肠镜检查）中，检测阳性率为 4.1%至 10.6%。随后进行结肠镜检查后，阳性患者的癌症率为 1.7%至 16.4%，高级腺瘤率为 7.1%至 23.1%。
结论
我们表明，两步法是越南结直肠癌筛查的一种有前途的策略，可能适用于资源有限的类似环境。
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