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Enhancing colorectal cancer screening in high-risk population through fecal immunochemical test surveillance: Results from a surveillance program

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机构: [1]Department of Colorectal Surgery, Tianjin Union Medical Center, Nankai University, Tianjin, China. [2]Department of Preventive and health care, Tianjin Union Medical Center, Nankai University, Tianjin, China. [3]Colorectal Cancer Screening Office, Tianjin Institute of Coloproctology, Tianjin, China. [4]Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [5]Cancer Prevention Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China. [6]Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [7]Department of Pathology, Tianjin Union Medical Center, Nankai University, Tianjin, China. [8]Laboratory of Oncologic Molecular Medicine, Tianjin Union Medical Center, Nankai University, Tianjin, China. [9]Shanghai Clinical Research Promotion and Development Center, Shanghai Hospital Development Center, Shanghai, China.
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关键词: cancer screening colorectal cancer fecal immunochemical testing surveillance

摘要:
Current guidelines recommend colonoscopy-based surveillance to decrease the risk of colorectal cancer (CRC) among these participants with above-average risk. The fecal immunochemical test (FIT) holds promise as a viable alternative surveillance tool, but the existing evidence regarding the use of settings remains limited. Therefore, our aim is to evaluate the CRC incidence rates in individuals with above-average CRC risk and the relationship between FIT surveillance and CRC incidence.The retrospective cohort study was performed based on the CRC screening program between January 2012 and December 2022, in Tianjin, China. This cohort study included 12,515 participants aged 40-74 years with above-average risk. The primary outcomes were the incidence rates of CRC and advanced colorectal neoplasia which were expressed as the number of events per 100,000 person-years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models.We included 12,515 participants aged 40-74 years, of whom 4980 received subsequent FIT surveillance during the study period. Among these participants, 51 CRC cases occurred in the non-FIT surveillance group (incidence rate, 233.88 per 100,000 person-years) and there were 29 cases of CRC in the FIT surveillance group (incidence rate, 184.85 per 100,000 person-years), resulting in an incidence rate ratio (IRR) of 0.58 (95% CI, 0.37-0.91). Meanwhile, 428 advanced colorectal neoplasia cases were reported in the non-FIT surveillance group, while 269 cases occurred in the FIT surveillance group, with significantly lower incidence of advanced colorectal neoplasia in the FIT surveillance group (IRR: 0.64; 95% CI, 0.55-0.74). Compared with the non-FIT surveillance group, the FIT surveillance group had a 54% decreased risk of developing CRC (HR, 0.46; 95% CI, 0.29-0.74) and a 45% decreased risk of developing advanced colorectal neoplasia (HR, 0.55; 95% CI, 0.47-0.64).In this retrospective cohort study, above-average risk individuals who received subsequent FIT in the intervals between colonoscopies were associated with a reduction of CRC and advanced colorectal neoplasia incidence, which indicated the value and utility of FIT in the surveillance program.© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.

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出版当年[2023]版:
大类 | 2 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
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出版当年[2022]版:
Q2 ONCOLOGY
最新[2024]版:
Q2 ONCOLOGY

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第一作者机构: [1]Department of Colorectal Surgery, Tianjin Union Medical Center, Nankai University, Tianjin, China. [2]Department of Preventive and health care, Tianjin Union Medical Center, Nankai University, Tianjin, China. [3]Colorectal Cancer Screening Office, Tianjin Institute of Coloproctology, Tianjin, China.
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通讯机构: [1]Department of Colorectal Surgery, Tianjin Union Medical Center, Nankai University, Tianjin, China. [3]Colorectal Cancer Screening Office, Tianjin Institute of Coloproctology, Tianjin, China. [4]Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [6]Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [9]Shanghai Clinical Research Promotion and Development Center, Shanghai Hospital Development Center, Shanghai, China.
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