筛查结肠镜检查对温室气体排放的纵向影响。
Longitudinal impact of screening colonoscopy on greenhouse gas emissions.
机构信息
Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States of America.
Division of Hematology &Oncology, Department of Internal Medicine, Jacobi Medical Center, New York City Health and Hospital Corporation, Bronx, New York, United States of America.
出版信息
PLoS One. 2024 Jul 19;19(7):e0307133. doi: 10.1371/journal.pone.0307133. eCollection 2024.
BACKGROUND AND AIM
Colonoscopy is the gold-standard screening test for colorectal cancer. However, it has come under scrutiny for its carbon footprint and contribution to greenhouse gas (GHG) emissions compared to other medical procedures. Notwithstanding, screening colonoscopies may have a positive effect on GHG emissions that is unknown. This study estimated the carbon emissions prevented by screening colonoscopies in the U.S.
METHODS
Using the reported number of screening colonoscopies performed annually in the U.S. and the absolute risk reduction (ARR) reported in the NorDICC trial, we calculated the expected minimum number of cancer treatment and surveillance visits prevented through screening based on the cancer stage. The average carbon emission averted per mile traveled was computed using the Environmental Protection Agency's (EPA) GHG equivalencies calculator. The final estimate of carbon emissions averted over a decade by screening colonoscopies performed in one year was determined.
RESULT
6.3 million screening colonoscopies performed in one year prevent 1,134,000 colorectal cancers over a ten-year period. Of these, 38∙3% (434,254) are localized, 38∙8% (440,281) are regional, and 22∙9% (259,465) are metastatic disease. The minimum number of post-diagnosis visits prevented is 11 for stage I, ≥ 21 for stage II, ≥25 for stage III, and ≥ 20 for stage IV disease, comprised of diagnostic, surgical evaluation, chemotherapy, and surveillance visits. The total number of visits prevented by screening is 2,388,397 for stage I, 5,254,421 for stage II, 13,120,369 for stage III, and 9,210,972 for stage IV disease. Approximately 395 million miles of travel and 158,263 metric tons of CO2, equivalent to 177 million pounds of coal burned, 19 billion smartphones charged, or 18 million gallons of gasoline consumed, were saved over ten years through screening.
CONCLUSION
Colorectal cancer screening decreases cancer-related GHG emissions and minimizes the environmental impact of cancer treatment.
背景与目的
结肠镜检查是结直肠癌的金标准筛查试验。然而，与其他医疗程序相比，它的碳足迹和对温室气体（GHG）排放的贡献受到了审查。尽管如此，筛查结肠镜检查可能对 GHG 排放产生未知的积极影响。本研究估计了美国筛查结肠镜检查预防的碳排放量。
方法
使用美国每年报告的筛查结肠镜检查数量和 NorDICC 试验报告的绝对风险降低（ARR），我们根据癌症分期计算了通过筛查预防的癌症治疗和监测就诊的预期最低次数。使用美国环境保护署（EPA）的 GHG 当量计算器计算每英里旅行避免的平均碳排放量。确定了一年内进行的筛查结肠镜检查在十年内避免的碳排放量的最终估计值。
结果
一年中进行的 630 万次筛查结肠镜检查可预防 113.4 万例结直肠癌，持续十年。其中，38∙3%（434,254 例）为局限性疾病，38∙8%（440,281 例）为区域性疾病，22∙9%（259,465 例）为转移性疾病。预防的最低诊断后就诊次数为 I 期 11 次，II 期≥21 次，III 期≥25 次，IV 期≥20 次，包括诊断、手术评估、化疗和监测就诊。通过筛查预防的就诊总数为 I 期 2,388,397 次，II 期 5,254,421 次，III 期 13,120,369 次，IV 期 9,210,972 次。通过筛查，在十年内节省了约 3.95 亿英里的旅行和 158,263 公吨的 CO2，相当于燃烧 1.77 亿磅煤、为 190 亿部智能手机充电或消耗 1800 万加仑汽油，从而减少了癌症相关的 GHG 排放，并使癌症治疗的环境影响最小化。
结论
结直肠癌筛查可降低癌症相关的 GHG 排放，并最大限度地减少癌症治疗的环境影响。
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