Supply and quality of colonoscopy according to the characteristics of gastroenterologists in the French population-based colorectalcancer screening program

作     者：AkoïKoïvogui Catherine Vincelet Gaëlle Abihsera Hamou Ait-Hadad Hélène Delattre Tu Le Trung Agnès Bernoux Rachel Carroll Jérôme Nicolet 

作者机构：Site de Seine-Saint-DenisCentre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Bondy 93146France Site des YvelinesCentre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Le Chesnay Cedex 78153France Site du Val-de-MarneCentre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Joinville-le-Pont 94340France Site de Seine-et-MarneCentre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Lieusaint 77763France Site des Hauts-de-SeineCentre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Nanterre 92000France site du Val-d’OiseCentre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Cergy Saint-Christophe 95800France Site de l’EssonneCentre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Fontenay-Les-Briis 91640France Siège ParisCentre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Paris 75015France 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2023年第29卷第9期

页      面：1492-1508页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Colorectal cancer screening Screening colonoscopy Faecal immunochemical test Guaiac faecal occult blood test Quality of colonoscopy Severity of tumor lesions 

摘      要：BACKGROUND Since its complete roll-out in 2009,the French colorectal cancer screening program(CRCSP)experienced 3 major constraints[use of a less efficient Guaiac-test(gFOBT),stopping the supply of Fecal-Immunochemical-Test kits(FIT),and suspension of the program due to the coronavirus disease 2019(COVID-19)]affecting its *** To describe the impact of the constraints in terms of changes in the quality of screeningcolonoscopy(Quali-Colo).METHODS This retrospective cohort study included screening-colonoscopies performed by gastroenterologists between Jan-2010 and Dec-2020 in people aged 50-74 living in Ile-de-France(France).The changes in Quali-colo(Proportion of colonoscopies performed beyond 7 mo(Colo_7 mo),Frequency of serious adverse events(SAE)and Colonoscopy detection rate)were described in a cohort of Gastroenterologists who performed at least one colonoscopy over each of the four periods defined according to the chronology of the constraints[gFOBT:Normal progress of the CRCSP using gFOBT(2010-2014);FIT:Normal progress of the CRCSP using FIT(2015-2018);STOP-FIT:Year(2019)during which the CRCSP experienced the cessation of the supply of test kits;COVID:Program suspension due to the COVID-19 health crisis(2020)].The link between each dependent variable(Colo_7 mo;SAE occurrence,neoplasm detection rate)and the predictive factors was analyzed in a two-level multivariate hierarchical *** The 533 gastroenterologists(cohort)achieved 21509 screening colonoscopies over gFOBT period,38352 over FIT,7342 over STOP-FIT and 7995 over COVID *** frequency of SAE did not change between periods(gFOBT:0.3%;FIT:0.3%;STOP-FIT:0.3%;and COVID:0.2%;P=0.10).The risk of Colo_7 mo doubled between FIT[adjusted odds ratio(aOR):1.2(1.1;1.2)]and STOPFIT[aOR:2.4(2.1;2.6)];then,decreased by 40%between STOP-FIT and COVID[aOR:2.0(1.8;2.2)].Regardless of the period,this Colo_7 mo’s risk was twice as high for screening colonoscopy performed in a public hospital[aOR:2.