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Impact of colorectal cancer screening participation in remote northern Canada:A retrospective cohort study

World Journal of Gastroenterology 2020年第48期26卷 7652-7663页

作者： Heather A Smith andrew d scarffe Nicole Brunet Cait Champion Kami Kandola Alisha Tessier Robin Boushey Craig Kuziemsky department of Surgery University of OttawaOttawa K1Y4E9OntarioCanada Telfer School of Management University of OttawaOttawa K1N6N5OntarioCanada Faculty of Medicine University of OttawaOttawa K1Y4E9OntarioCanada department of Surgery Northern Ontario School of MedicineSudbury P3E2C6OntarioCanada department of Health and Social Services Government of the Northwest TerritoriesYellowknife X1A1P5Northwest TerritoriesCanada department of Surgery Stanton Territorial Health AuthorityYellowknife X1A0H1Northwest TerritoriesCanada division of General Surgery University of OttawaOttawa K1H 8L6OntarioCanada Office of Research Services MacEwan UniversityEdmonton T5J4S2AlbertaCanada

BACKGROUNd Screening provides earlier colorectal cancer(CRC)detection and improves *** remains poorly understood if these benefits are realized with screening guidelines in remote northern populations of Canada where CRC rates are nearly twice the national average and access to colonoscopy is *** To evaluate the participation and impact of CRC screening guidelines in a remote northern *** This retrospective cohort study included residents of the Northwest Territories,a northern region of Canada,age 50-74 who underwent CRC screening by a fecal immunohistochemical test(FIT)between January 1,2014 to March 30,*** assess impact,individuals with a screen-detected CRC were compared to clinically-detected CRC cases for stage and location of CRC between *** assess participation,we conducted subgroup analyses of FIT positive individuals exploring the relationships between signs and symptoms of CRC at the time of screening,wait-times for colonoscopy,and screening *** sample Welch t-test was used for normally distributed continuous variables,Mann-Whitney-Wilcoxon Tests for data without normal distribution,and Chi-square goodness of fit test for categorical variables.A P value ofdered to be statistically *** 6817 fecal tests were completed,meaning an annual average screening rate of 25.04%,843(12.37%)were positive,629 individuals underwent a follow-up colonoscopy,of which,24.48%had advanced neoplasia(AN),5.41%had *** were no significant differences in stage,pathology,or location between screen-detected cancers and clinically-detected *** assessing participation and screening outcomes,we observed 49.51%of individuals referred for colonoscopy after FIT were ineligible for CRC screening,most often due to signs and symptoms of *** were more likely to have AN if they had signs and symptoms of cancer at the time of screening,waited over 180 d for colonoscopy,or were indigenous[

关键词： Gastroenterology Rural health services Public health Colorectal neoplasms Early detection of cancer Northwest Territories

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