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首页> 外文期刊>Surgical Endoscopy >Colorectal cancer following negative colonoscopy: is 5-year screening the correct interval to recommend?
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Colorectal cancer following negative colonoscopy: is 5-year screening the correct interval to recommend?

机译：阴性结肠镜检查后的结直肠癌：5年筛选正确的间隔建议吗？

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Despite the high sensitivity of screening colonoscopy, polyps and cancers can still go undetected. With the polyp-to-cancer transformation cycle averaging 7-10 years, present guidelines recommend repeat colonoscopy within 10 years after negative screening. However, not all colorectal malignancies follow this decade-long progression. This study evaluates the incidence and pathology of colorectal cancers following a previous negative screening colonoscopy.Records of patients who underwent a colectomy at our institution, from 1998 to 2009, were reviewed retrospectively. A total of 1,784 patient records were screened using exclusion criteria for inclusion in this study. The patients were divided as follows: Group 1 included patients with a negative colonoscopy within the previous 5 years; Group 2 included patients without a previous colonoscopy or with a previous colonoscopy more than 5 years prior. Group 1 patients were evaluated by colonoscopy for anemia, diverticulitis, signs of obstruction, and bleeding. Age, tumor location, operation performed, and pathology findings were recorded. The χ(2) test and paired t test were used for statistical analysis.A total of 233 patients were included in this study. Group 1 contained 43 patients with a mean age of 73 years (range = 35-94, median = 75). Group 2 had 190 patients with a mean age of 68 years (range = 19-91, median = 70). Group 1 consisted of 18 male and 25 female patients, and Group 2 included 94 male and 96 female patients. Both groups were further classified into the following age categories: <50 years, 50-80 years, and >80 years. Eighteen percent of the total study population had newly discovered colorectal cancer within a 5-year colonoscopy screening period. There were no significant differences in the distribution of the T and N stages between the two groups and no statistically significant differences when the rate of lymphovascular invasion (19 vs. 17 %; p = 0.39) and perineural invasion (7 vs. 11 %; p = 0.58) were compared.Within 5 years, 18 % of our study population developed colorectal cancer. Most of these malignancies were found within the 50-80-year age group and located predominantly in the right colon and distally in the sigmoid and rectum. While distal cancers may be visualized by flexible sigmoidoscopy, those located more proximally may be missed, necessitating the need for a full colonoscopy. Although staging was similar between the two groups, Group 1 tumors were less aggressive despite having appeared within 5 years. As a result of our incidence of colorectal cancer within a 5-year interval, a shorter period for routine colonoscopy may be considered.
机译：尽管对筛选结肠镜检查的敏感性很高，但息肉和癌症仍然可以未被发现。随着息肉到癌症的转化周期平均为7 - 10年，目前的指南建议在阴性筛查后10年内重复结肠镜检查。然而，并非所有结肠直肠恶性肿瘤都遵循这十年的长期进展。本研究评估了前一种阴性筛查结肠透视后结肠直肠癌的发病率和病理学。回顾性地审查了1998年至2009年在我们的机构接受过高素素的患者的患者。使用排除标准筛选出总共1,784名患者记录以纳入本研究。患者分为如下：第1组包括在过去5年内的阴性综合镜检查的患者;第2组包括没有先前结肠镜检查的患者或之前的结肠镜检查超过5年。第1组患者通过结肠镜检查进行贫血，憩室炎，梗阻症状和出血。记录年龄，肿瘤位置，操作，并记录病理结果。 △（2）试验和配对T试验用于统计学分析。本研究中包含233名患者。第1组含有43名患者，平均年龄为73岁（范围= 35-94，中位数= 75）。第2组有190名患者，平均年龄为68岁（范围= 19-91，中位数= 70）。第1组由18名男性和25名女性患者组成，第2组包括94名男性和96名女性患者。这两组进一步分为以下年龄类别：<50年，50 - 80岁，和80岁。总研究人群的18％在5年的结肠综查期内新发现结肠直肠癌。两组之间的T和N阶段的分布没有显着差异，并且当淋巴血管侵袭率（19 vs.17％; p = 0.39）和麻纹侵袭时没有统计学上显着的差异（7 vs.11％;比较p = 0.58）。在5年内，我们的研究人群中的18％发育了结直肠癌。这些恶性肿瘤中的大部分是在50-80岁的年龄组中发现的，主要位于右旋组织中，在统计和直肠上远侧。虽然远端癌症可以通过柔性乙型过镜检查可视化，但是可以错过更近端的那些，而是需要完整的结肠镜检查。虽然两组之间的分期相似，但尽管在5年内出现，但第1组肿瘤的肿瘤仍不那么激进。由于我们在5年间隔内的结肠直肠癌发病率，可以考虑常规结肠镜检查的较短时期。

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