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因女性、年龄及结肠直肠癌患病风险增加所引起的可屈性乙状结肠镜筛查结果不完全

世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 36-36页

作者： Doria-Rose V.P. Newcomb P.A. Levin T.R. 廖新华 Fred Hutchinson Cancer Research Center 1100 Fairview Ave North Seattle WA 98109-1024 United States Dr.

Background: Several previous studies have found that females and older individuals are at greater risk of having incomplete flexible sigmoidoscopy. However, no prior study has reported the subsequent risk of colorectal cancer (CRC) following incomplete sigmoidoscopy. Methods: Using data from 55 791 individuals screened as part of the Colon Cancer Prevention (CoCaP) programme of kaiser Permanente of Northern California, we evaluated the likelihood of having an inadequate (< 40 cm) examination by age and sex, and estimated the risk of distal CRC according to depth of sigmoidoscope insertion at the baseline screening examination. Multivariate estimation of risks was performed using Poisson regression. Results: Older individuals were at a much greater risk of having an inadequate examination (relative risk (RR) for age 80+ years compared with 50-59 years 2.6 (95% confidence interval (Cl) 2.3-3.0)), as were females (RR 2.3 (95% Cl 2.2-2.5)); these associations were attenuated but remained strong if Poisson models were further adjusted for examination limitations (pain, stool, and angulation). There was an approximate threefold increase in the risk of distal CRC if the baseline sigmoidoscopy did not reach a depth of at least 40 cm; a smaller increase in risk was observed for examinations that reached 40-59 cm. Conclusions: Older individuals and women are at an increased risk of having inadequate sigmoidoscopy. Because inadequate sigmoidoscopy results in an increased risk of subsequent CRC, physicians should consider steps to maximise the depth of insertion of the sigmoidoscope or, failing this, should consider an alternative screening test.

关键词：结肠直肠癌乙状结肠镜患病风险筛查结果筛查方法结肠癌北加利福尼亚 Poisson kais

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