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乙状结肠镜检查筛查(包括结肠镜检查)对结直肠癌的影响:基于随机对照试验的分析

Effects of sigmoidoscopy screening (including colonoscopy) on colorectal cancer: A -analysis based on randomized controlled trials.

作者信息

Wang Dongying, Xu Qian, Dai Senjie, Zhang Yueming, Ding Fulin, Ji Linling

机构信息

The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.

Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.

出版信息

Prev Med Rep. 2024 Feb 1;39:102636. doi: 10.1016/j.pmedr.2024.102636. eCollection 2024 Mar.

Abstract

BACKGROUND

This study aimed to investigate the role of endoscopy screening in colorectal cancer (CRC).

METHODS

Up to January 2023, databases were searched for studies related to sigmoidoscopy and colonoscopy screening. The incidence of CRC, and/or CRC mortality were the main observation outcomes.

RESULTS

A total of 5 randomized controlled trials (RCTs) published from 2017 to 2022 were included. Among them, four studies used sigmoidoscopy screening and one study involved colonoscopy screening. Statistical results showed that the incidence (RR: 0.78, p < 0.001) and mortality (RR: 0.75, p < 0.001) of CRC were significantly lower in the screening group than in the control group. Further, a subgroup analysis of CRC site indicated that the incidence and mortality of CRC in the screening group were significantly lower than those in the non-screened group, regardless of distal CRC (Incidence: RR: 0.66, p < 0.001; Mortality: RR: 0.62, p < 0.001) or proximal CRC (Incidence: RR: 0.94, p = 0.038; Mortality: RR: 0.89, p = 0.038). In terms of gender, compared with the non-screening group, both males (Incidence: RR: 0.73, p < 0.001; Mortality: RR: 0.68, p < 0.001) and females (Incidence: RR: 0.85, p < 0.001; Mortality: RR: 0.85, p = 0.017), the screening group had a significant decrease in the incidence and mortality of CRC.

CONCLUSION

This -analysis demonstrated that sigmoidoscopy screening (including colonoscopy) could effectively reduce the incidence and mortality of CRC.

摘要

背景

本研究旨在探讨内镜筛查在结直肠癌(CRC)中的作用。

方法

截至2023年1月,检索数据库中与乙状结肠镜检查和结肠镜检查筛查相关的研究。结直肠癌的发病率和/或结直肠癌死亡率为主要观察结果。

结果

共纳入2017年至2022年发表的5项随机对照试验(RCT)。其中,4项研究采用乙状结肠镜检查筛查,1项研究涉及结肠镜检查筛查。统计结果显示,筛查组结直肠癌的发病率(RR:0.78,p<0.001)和死亡率(RR:0.75,p<0.001)显著低于对照组。此外,对结直肠癌部位的亚组分析表明,无论远端结直肠癌(发病率:RR:0.66,p<0.001;死亡率:RR:0.62,p<0.001)还是近端结直肠癌(发病率:RR:0.94,p = 0.038;死亡率:RR:0.89,p = 0.038),筛查组结直肠癌的发病率和死亡率均显著低于未筛查组。在性别方面,与未筛查组相比,筛查组男性(发病率:RR:0.73,p<0.001;死亡率:RR:0.68,p<0.001)和女性(发病率:RR:0.85,p<0.001;死亡率:RR:0.85,p = 0.017)的结直肠癌发病率和死亡率均显著降低。

结论

本分析表明,乙状结肠镜检查筛查(包括结肠镜检查)可有效降低结直肠癌的发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e16b/10847765/aa9cf6322021/gr1.jpg

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