年龄对结直肠癌监测策略偏好的影响：粪便免疫化学检测是否适合用于监测？

The Impact of Age on Preferences for Colorectal Cancer Surveillance Strategies: Are Fecal Immunochemical Tests FIT for Surveillance?

作者信息

Dix Maddison, Cohen-Woods Sarah, Wassie Molla M, Winter Jean M, Wilson Carlene J, Young Graeme P, Cock Charles, Symonds Erin L

机构信息

Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

Institute for Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia.

出版信息

Cancer Med. 2025 Mar;14(5):e70723. doi: 10.1002/cam4.70723.

DOI:10.1002/cam4.70723

PMID:40029035

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11873988/

Abstract

INTRODUCTION

Individuals with a known risk of colorectal cancer (CRC) are recommended regular surveillance colonoscopies. Alternative surveillance strategies incorporating fecal immunochemical tests (FIT) may improve colonoscopy resource utilization and be more appropriate for those with a lower risk of CRC, particularly younger adults. This study compared younger (< 50 years) and older (≥ 50 years) adults' preferences for different CRC surveillance strategies.

METHODS

Eight hundred individuals enrolled in a colonoscopy-based surveillance program were invited to complete a survey assessing CRC surveillance preferences. Preferences for colonoscopy frequency and the acceptability of two alternative protocols were assessed: (1) providing FIT between colonoscopies, and (2) a FIT-only strategy where colonoscopy would only be required after a positive FIT result.

RESULTS

A total of 102 younger (median age 41.4 years, 67.6% female) and 187 older (median age 68.5 years, 49.2% female) adults completed the survey. Surveillance preferences did not significantly vary by age group; most respondents preferred colonoscopies more often than their current frequency (< 50 years: 54.1%; ≥ 50 years: 58.1%). Although most participants (< 50 years: 91.2%; ≥ 50 years: 93.0%) agreed that FIT is important to complete between surveillance colonoscopies, only a small proportion were comfortable with FIT-only surveillance replacing colonoscopies (< 50 years: 27.5%; ≥ 50 years: 37.4%). Fear of CRC was a significant predictor of preferences for more frequent surveillance incorporating FIT in younger, but not older, adults.

CONCLUSION

Many individuals with an elevated risk of CRC wanted more frequent surveillance, regardless of their age. Extending surveillance colonoscopy intervals using FIT may be a more acceptable method of reducing colonoscopy frequency rather than utilizing a FIT-only approach.

TRIAL REGISTRATION

This study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN #12619001743156).

摘要

引言

对于已知有结直肠癌（CRC）风险的个体，建议定期进行结肠镜监测。采用粪便免疫化学检测（FIT）的替代监测策略可能会提高结肠镜资源的利用率，并且更适合CRC风险较低的人群，尤其是年轻成年人。本研究比较了年轻（<50岁）和年长（≥50岁）成年人对不同CRC监测策略的偏好。

方法

邀请800名参加基于结肠镜检查的监测项目的个体完成一项评估CRC监测偏好的调查。评估了对结肠镜检查频率的偏好以及两种替代方案的可接受性：（1）在结肠镜检查之间提供FIT；（2）仅采用FIT策略，即仅在FIT结果呈阳性后才需要进行结肠镜检查。

结果

共有102名年轻成年人（中位年龄41.4岁，67.6%为女性）和187名年长成年人（中位年龄68.5岁，49.2%为女性）完成了调查。监测偏好未因年龄组而有显著差异；大多数受访者希望比当前频率更频繁地进行结肠镜检查（<50岁：54.1%；≥50岁：58.1%）。尽管大多数参与者（<50岁：91.2%；≥50岁：93.0%）同意在结肠镜检查之间完成FIT很重要，但只有一小部分人对仅采用FIT监测替代结肠镜检查感到满意（<50岁：27.5%；≥50岁：37.4%）。对CRC的恐惧是年轻成年人（而非年长成年人）更频繁采用包含FIT的监测偏好的一个重要预测因素。