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研究通讯:筛查结肠镜检查对结直肠癌死亡率的影响:随机试验比较分析的经验教训

Research Communication: Effects of Screening Colonoscopy on Colorectal Cancer Mortality: Lessons From Comparative Analyses of Randomised Trials.

作者信息

Brenner Hermann, Sergeev Dmitry, Heisser Thomas, Hoffmeister Michael

机构信息

Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.

German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.

出版信息

Aliment Pharmacol Ther. 2025 Sep;62(6):656-659. doi: 10.1111/apt.70231. Epub 2025 Jun 10.

Abstract

NordICC, the first randomised trial on long-term effects of screening colonoscopy, failed to demonstrate a significant reduction in colorectal cancer (CRC) mortality. We compared reported 10-year CRC mortality results from NordICC with those of NORCCAP, a similarly designed pragmatic sigmoidoscopy trial. In NORCCAP, differences in CRC mortality only began to emerge after 9.5 years of follow-up, rapidly increased thereafter and were approximately 4-fold as high after 12 years than after 10 years. Other sigmoidoscopy trials yielded similar 11- to 12-year results. Our analysis suggests that the apparent negative CRC mortality results of NordICC primarily reflect insufficient follow-up time.

摘要

NordICC是第一项关于结肠镜筛查长期效果的随机试验,未能证明结直肠癌(CRC)死亡率有显著降低。我们将NordICC报告的10年CRC死亡率结果与NORCCAP(一项设计类似的实用乙状结肠镜检查试验)的结果进行了比较。在NORCCAP中,CRC死亡率的差异仅在随访9.5年后才开始显现,此后迅速增加,12年后约为10年后的4倍。其他乙状结肠镜检查试验也得出了类似的11至12年结果。我们的分析表明,NordICC明显的CRC死亡率阴性结果主要反映了随访时间不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed0a/12395887/e4ee2c65a2c7/APT-62-656-g001.jpg

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