期刊
INTERNATIONAL JOURNAL OF CANCER
卷 149, 期 6, 页码 1257-1265出版社
WILEY
DOI: 10.1002/ijc.33682
关键词
colorectal cancer; fecal immunochemical test; incidence; mortality; screening; upper age limit
类别
Limited endoscopy capacity is a main barrier to extending screening for colorectal cancer to individuals over 70 years old, due to the high positivity rate in this age group. A study assessing CRC incidence and mortality among 70-year-olds with negative fecal immunochemical tests (FIT) found that those with previous negative FIT results had lower 10-year cumulative rates of cancer incidence and mortality compared to those who had not participated in screening or had positive FIT results. Therefore, optimizing resources by targeting screening efforts towards individuals aged 70 to 74 with no previous negative FIT results may be a more efficient approach.
Limited endoscopy capacity usually represents the main barrier to the extension of screening to subjects older than 70, given the high positivity rate in this age group. We assessed CRC incidence and mortality by number of previous negative fecal immunochemical tests (FIT) among subjects turning 70. We selected persons aged 70 years who had received their last screening invitation when they were 68 or 69 years old within the population-based screening program in the Veneto region of Italy. Subjects with a positive FIT were excluded. We calculated 10-year cumulative CRC incidence and mortality in cohorts of subjects having performed zero, one, two or three negative FITs over the last three screening rounds before turning 70. Out of 117 858 subjects included in the study (46.4% men), 33.7% had never participated in screening (zero negative FITs), 23.3% had had one-negative FIT, 20.1% two-negative FITs and 22.9% three negative FITs. The 10-year cumulative CRC incidence was 29.7 per 1000 subjects with zero FITs, and respectively, 14.5, 11.7 and 9.6 per 1000 subjects with one, two and three negative FITs. The corresponding figures for 10-year cumulative mortality were 9.3, 3.5, 2.2 and 2.1 per 1000 in the four study cohorts. Figures were roughly double for men than for women for all the study cohorts. In order to use more efficiently limited endoscopy resources, and to minimize the potential harms related to false positive results in the elderly, screening among people aged 70 to 74 might be restricted to those with zero previous negative FITs.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据