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瑞士结直肠癌筛查的十年变化:2007年、2012年和2017年瑞士健康访谈调查

Ten-year changes in colorectal cancer screening in Switzerland: The Swiss Health Interview Survey 2007, 2012 and 2017.

作者信息

Schneider Rémi, Syrogiannouli Lamprini, Bissig Sarah, Scharf Tamara, Bulliard Jean-Luc, Ducros Cyril, Del Giovane Cinzia, Tal Kali, Zwahlen Marcel, Selby Kevin, Auer Reto

机构信息

Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.

Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

出版信息

Prev Med Rep. 2022 May 6;27:101815. doi: 10.1016/j.pmedr.2022.101815. eCollection 2022 Jun.

Abstract

Recent recommendations for colorectal cancer (CRC) screening suggest fecal occult blood test (FOBT) or colonoscopy. Since 2013, mandatory health insurance in Switzerland reimburse CRC screening. We set out to determine if CRC testing rate and type of CRC screening changed in Switzerland from 2007 to 2017 and between the three main language regions. We extracted data on 50-75-year-olds from the Swiss Health Interview Survey (SHIS) 2007, 2012 and 2017 to determine rates of self-reported testing with FOBT within last 2 years and colonoscopy within last 10 years. We estimated prevalence ratio (PR) in multivariate-adjusted logistic regression models and compared rates in German-, French- and Italian-speaking regions, adjusting for sociodemographic, self-rated health and insurance variables. Overall testing rates (FOBT or colonoscopy) increased in all regions from 2007 to 2017 (German-speaking 33.6% to 48.3%; French-speaking 30.8% to 48.8%; Italian-speaking 37.9% to 46.8%), mainly because of an increase in colonoscopy rate for screening reasons (p < 0.001 in all regions). Rates of FOBT testing fell significantly in the German-speaking region (11.9% to 4.4%, p < 0.001), but not in the Italian- (13.9% to 8.5%, p = 0.052) and French-speaking regions (7.6% to 7.4%, p = 0.138). Overall CRC testing rate rose from 33.2% in 2007 to 48.4% in 2017, mainly because of an increase of colonoscopy rate for screening reasons. Coverage remains below the 65% target of European guidelines. Organized screening programs encouraging FOBT screening could contribute to further increasing the CRC testing rate.

摘要

近期针对结直肠癌(CRC)筛查的建议推荐了粪便潜血试验(FOBT)或结肠镜检查。自2013年起,瑞士的强制性医疗保险开始报销CRC筛查费用。我们旨在确定2007年至2017年期间瑞士CRC检测率及CRC筛查类型是否发生变化,以及在三个主要语言区域之间是否存在差异。我们从2007年、2012年和2017年的瑞士健康访谈调查(SHIS)中提取了50至75岁人群的数据,以确定过去2年内自我报告的FOBT检测率以及过去10年内的结肠镜检查率。我们在多变量调整的逻辑回归模型中估计患病率比(PR),并比较德语区、法语区和意大利语区的检测率,同时对社会人口统计学、自我评估健康状况和保险变量进行了调整。从2007年到2017年,所有地区的总体检测率(FOBT或结肠镜检查)均有所上升(德语区从33.6%升至48.3%;法语区从30.8%升至48.8%;意大利语区从37.9%升至46.8%),主要原因是出于筛查目的的结肠镜检查率上升(所有地区p<0.001)。FOBT检测率在德语区显著下降(从11.9%降至4.4%,p<0.001),但在意大利语区(从13.9%降至8.5%,p=0.052)和法语区(从7.6%降至7.4%,p=0.138)未出现显著下降。总体CRC检测率从2007年的33.2%升至2017年的48.4%,主要原因是出于筛查目的的结肠镜检查率上升。覆盖率仍低于欧洲指南设定的65%的目标。鼓励FOBT筛查的有组织筛查计划可能有助于进一步提高CRC检测率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32f1/9152794/f67554b37b72/gr1.jpg

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