Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China.
Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China.
Cancer Epidemiol. 2022 Aug;79:102184. doi: 10.1016/j.canep.2022.102184. Epub 2022 May 14.
This is the first evaluation study to assess the demographic characteristics of the colorectal cancer (CRC) cases detected in the prevalent round of the population-based Colorectal Cancer Screening Programme (CRCSP) in Hong Kong and to explore the effectiveness of the programme on the stage distribution of CRC.
This study covered the period between 28 September 2016 and 31 December 2018. Information on CRC diagnosis, age and stage at diagnosis were retrieved and reviewed by the Hong Kong Cancer Registry (HKCaR). The CRC detection rate among CRCSP-screened participants and incidence rate among the Hong Kong general population were calculated respectively. The odds ratio (OR) was calculated to measure the strength of association and quantify the effect of CRCSP on stage shift between CRCSP-detected CRC cases and an age-matched cohort of CRC cases diagnosed outside the programme.
The CRC detection rate among participants of the CRCSP during the study period was 736.0/100,000, whereas the overall CRC incidence rate among general population of similar age groups was 393.7/100,000. For all ages and both sexes, the OR of stage I CRCSP-detected CRC compared to the CRC from the age-matched cohort was 3.91 (95%CI=3.41-4.48) and the OR dropped to 0.54 (95%CI=0.41-0.70) at stage IV. Meanwhile, the overall OR of CRCSP-detected CRC compared to CRC from the age-matched cohort dropped from 2.24 (95%CI=1.97-2.56) to 1.62 (95%CI=1.40-1.87) with increasing age.
The present study has demonstrated the initial impact of the CRCSP on shifting the stage at diagnosis towards earlier stage. The benefit of stage-shift was similar for all ages from 60 to 77 in both sexes and seems to increase with younger age. Given the stage-dependent survival outcomes, this stage-shift could lead to a reduction in CRC-associated mortality in Hong Kong in future.
这是第一项评估研究，旨在评估香港基于人群的结直肠癌筛查计划（CRCSP）中发现的结直肠癌（CRC）病例的人口统计学特征，并探讨该计划对 CRC 分期分布的有效性。
本研究涵盖了 2016 年 9 月 28 日至 2018 年 12 月 31 日期间。CRC 诊断信息、年龄和诊断时的分期由香港癌症登记处（HKCaR）检索和审核。分别计算 CRCSP 筛查参与者的 CRC 检出率和香港一般人群的发病率。计算比值比（OR）以衡量关联强度，并量化 CRCSP 对 CRCSP 检出的 CRC 病例与计划外诊断的年龄匹配的 CRC 病例之间分期转移的影响。
在研究期间，CRCSP 参与者的 CRC 检出率为 736.0/100,000，而年龄组相似的一般人群的总体 CRC 发病率为 393.7/100,000。对于所有年龄和性别，与年龄匹配队列中的 CRC 相比，I 期 CRCSP 检出的 CRC 的 OR 为 3.91（95%CI=3.41-4.48），而在 IV 期，OR 降至 0.54（95%CI=0.41-0.70）。同时，与年龄匹配队列中的 CRC 相比，CRCSP 检出的 CRC 的总体 OR 从 2.24（95%CI=1.97-2.56）降至 1.62（95%CI=1.40-1.87）随着年龄的增长。
本研究表明 CRCSP 初步影响了诊断分期向早期阶段转移。对于所有年龄组（60-77 岁），无论性别，这种分期转移的益处是相似的，并且似乎随着年龄的减小而增加。鉴于与生存结果相关的阶段，这种分期转移可能会导致香港未来 CRC 相关死亡率降低。
