75岁以上首次进行结肠癌筛查能否降低癌症风险且无重大并发症？来自美国一项大型回顾性研究的见解。
Does First-Time Colon Cancer Screening Beyond Age 75 Reduce Cancer Risk Without Significant Complications? Insights From a Large US Retrospective Study.
作者信息
Hussain Azhar, Paladiya Ruchir, Shahzil Muhammad, Sarfraz Shiza, Khalil Kalsoom, Hayat Umar, Dahiya Dushyant Singh, Ali Hassam
机构信息
Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
Department of Internal Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
出版信息
Cancer Med. 2025 Sep;14(17):e71200. doi: 10.1002/cam4.71200.
INTRODUCTION
Colorectal cancer (CRC) is a leading cause of global cancer-related morbidity and mortality. This study examines the impact of first-time screening colonoscopy on CRC incidence in obese individuals aged 75 and older using a large US retrospective cohort.
METHODS
Obese adults aged ≥ 75 were divided into two groups: those undergoing their first screening colonoscopy after 75 (Cases) and those without prior colonoscopy (Controls), using TrinetX database data.
RESULTS
Propensity-matched cohorts of 123,930 patients each showed reduced CRC incidence (0.08% vs. 0.52%; OR: 0.157, p < 0.001) and lower all-cause mortality (9.6% vs. 17.3%; OR: 0.510, p < 0.001) in the colonoscopy group. The number needed to treat to prevent one CRC case was 227. Perforation rates were similar (0.2%, p = NS), but gastrointestinal bleeding was higher (5.2% vs. 4.4%; OR: 1.187, p < 0.001).
CONCLUSION
Screening colonoscopy after age 75 significantly reduces CRC incidence and mortality, with manageable complication rates.
引言
结直肠癌（CRC）是全球癌症相关发病和死亡的主要原因。本研究使用美国大型回顾性队列研究，探讨首次筛查结肠镜检查对75岁及以上肥胖个体结直肠癌发病率的影响。
方法
使用TrinetX数据库数据，将年龄≥75岁的肥胖成年人分为两组：75岁后接受首次筛查结肠镜检查的患者（病例组）和未接受过结肠镜检查的患者（对照组）。
结果
倾向评分匹配后的队列中，每组123,930例患者，结肠镜检查组的结直肠癌发病率降低（0.08%对0.52%；OR：0.157，p<0.001），全因死亡率降低（9.6%对17.3%；OR：0.510，p<0.001）。预防一例结直肠癌病例所需的治疗人数为227。穿孔率相似（0.2%，p=无显著性差异），但胃肠道出血发生率较高（5.2%对4.4%；OR：1.187，p<0.001）。
结论
75岁后进行筛查结肠镜检查可显著降低结直肠癌发病率和死亡率，并发症发生率可控。
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