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首页> 美国卫生研究院文献>Gut >Incomplete screening flexible sigmoidoscopy associated with female sex age and increased risk of colorectal cancer
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Incomplete screening flexible sigmoidoscopy associated with female sex age and increased risk of colorectal cancer

机译：与女性年龄和大肠癌风险增加相关的灵活乙状结肠镜筛查不完全

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>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 (CI) 2.3–3.0)), as were females (RR 2.3 (95% CI 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.
机译：>背景：先前的一些研究发现，女性和年长的个体有较高的不完全柔性乙状结肠镜检查风险。但是，没有先前的研究报告过乙状结肠镜检查不完全之后发生结直肠癌（CRC）的风险。>方法：使用Kaiser Permanente结肠癌预防（CoCaP）计划的一部分筛查的55791名个体的数据在北加州，我们根据年龄和性别评估了检查不足（<40 cm）的可能性，并根据基线筛查检查中乙状结肠镜插入的深度估算了远端CRC的风险。使用Poisson回归进行风险的多变量估计。>结果：年龄较大的个体80岁以上的患者接受检查不足的风险（相对风险（RR））要比50-59岁的更大（2.6） （95％置信区间（CI）2.3-3.0）），女性也是如此（RR 2.3（95％CI 2.2-2.5））；如果针对检查限制（疼痛，大便和成角度）进一步调整Poisson模型，这些关联会减弱，但仍然保持强势。如果基线乙状结肠镜检查未达到至少40 cm的深度，远端CRC的风险大约增加三倍。在达到40-59 cm的检查中，观察到的风险增加较小。>结论：年龄较大的个人和女性因乙状结肠镜检查不适当的风险增加。由于乙状结肠镜检查不足会导致随后发生CRC的风险增加，因此医师应考虑采取措施以最大程度地增加乙状结肠镜的插入深度，否则，应考虑采用另一种筛查试验。

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