Aickin M, Alberts D S
Arizona Cancer Center, University of Arizona, Tucson 85724, USA.
Eur J Cancer Prev. 1996 Feb;5(1):43-8.
Adenomatous polyps are regarded as the dominant precursor lesion of colon cancer. For four decades the occurrence of adenomas has been investigated, both in observational studies and in controlled, randomized cancer-prevention studies. During this period, little consensus has been reached with regard to the data that should be reported in such studies. The emerging consensus on the methods of analysing the results does not have a firm biostatistical basis, and does not deal appropriately with the phenomenon of colonoscopy avoidance. We review a simple biostatistical method that is appropriate, and apply it to a selected recent series of studies. Our finding is that there are common patterns of adenoma occurrence across these studies, with a rate of 0.3-0.4 per year in the first year following polypectomy, dropping to 0.1-0.15 in subsequent years. The method of analysis also serves to highlight exceptions to this pattern.
腺瘤性息肉被视为结肠癌的主要前驱病变。四十年来，无论是在观察性研究还是在对照、随机的癌症预防研究中，都对腺瘤的发生情况进行了调查。在此期间，对于此类研究应报告的数据几乎没有达成共识。关于结果分析方法的新共识缺乏坚实的生物统计学基础，并且没有妥善处理结肠镜检查规避现象。我们回顾了一种合适的简单生物统计学方法，并将其应用于近期一系列选定的研究。我们的发现是，这些研究中腺瘤的发生存在共同模式，息肉切除术后第一年的发生率为每年0.3 - 0.4，随后几年降至0.1 - 0.15。分析方法也有助于突出这种模式的例外情况。
