Plantener Eva, Deding Ulrik, Madsen Jeppe Buur, Kroijer Rasmus, Madsen Jonna Skov, Baatrup Gunnar
Odense University Hospital, Department of Surgery, Svendborg, Denmark.
University of Southern Denmark, Department of Clinical Research, Odense, Denmark.
Endosc Int Open. 2022 Apr 14;10(4):E413-E419. doi: 10.1055/a-1743-2651. eCollection 2022 Apr.
Of the participants in the Danish screening program, 89.9 % to 92.5 % have fecal immunochemical test (FIT) values < 10 μg/g feces (equivalent to 50 ng hemoglobin/mL buffer). This study aimed to investigate the risk of interval colorectal cancer (CRC) in this group before the next biennial screening round. This cohort study included all citizens from the region of Southern Denmark who participated in the Danish bowel screening program from 2014 trough 2016 and had a FIT value < 10 μg/g feces. Individuals receiving a CRC diagnosis were identified through the national CRC registry, with a follow up of 2 years corresponding to the current screening interval. We also examined the 3-year CRC incidence. Hazard ratios (HRs) were estimated using univariate and multivariate Cox proportional hazard regression models. Data from 185,654 citizens presenting with a FIT value < 10 μg/g feces were eligible for analysis. Overall, interval CRC incidence was 0.07 % within 2 years with HRs of 4.16 (95 % confidence interval [CI] 2.67;6.48) and 5.8 (95 % CI 3.34;10.05) for FIT values of 4 to 6.9 μg/g feces and 7 to 9.9 μg/g feces, respectively, compared to those having a FIT value below the limit of quantification of 4 μg/g feces. After 3 years, the overall CRC incidence increased to 0.14 %; however, this was not significant. This study demonstrates a positive correlation between FIT value and risk of interval cancer even for very low values. It further suggests that an increase in the screening interval could be reasonable in the low FIT categories.
在丹麦筛查项目的参与者中，89.9%至92.5%的人粪便免疫化学检测（FIT）值<10μg/g粪便（相当于50ng血红蛋白/mL缓冲液）。本研究旨在调查该组在下一轮两年一次的筛查之前发生间期结直肠癌（CRC）的风险。这项队列研究纳入了2014年至2016年参与丹麦肠道筛查项目且FIT值<10μg/g粪便的丹麦南部地区所有公民。通过国家CRC登记处确定接受CRC诊断的个体，并进行了相当于当前筛查间隔的2年随访。我们还检查了3年CRC发病率。使用单变量和多变量Cox比例风险回归模型估计风险比（HRs）。185,654名FIT值<10μg/g粪便的公民的数据符合分析条件。总体而言，2年内间期CRC发病率为0.07%，粪便FIT值为4至6.9μg/g和7至9.9μg/g的人群，与FIT值低于定量下限4μg/g的人群相比，HR分别为4.16（95%置信区间[CI]2.67；6.48）和5.8（95%CI 3.34；10.05）。3年后，总体CRC发病率升至0.14%；然而，这并不显著。这项研究表明，即使FIT值非常低，其与间期癌症风险之间也存在正相关。它进一步表明，对于低FIT类别，延长筛查间隔可能是合理的。
