期刊
CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
卷 12, 期 5, 页码 -出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.14309/ctg.0000000000000350
关键词
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资金
- National Research Foundation of Korea [2019R1A2C1007859]
- Ministry of Science and ICT
- National R&D Program for Cancer Control [HA17C0046]
- Korean National Health Clinical Research (NHCR), Ministry of Health & Welfare, Republic of Korea [HC16C2320]
- Basic Science Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education [2020R1I1A306686511]
- National Research Foundation of Korea [2019R1A2C1007859] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
Colonoscopy is more effective in reducing the risk of distal CRC compared with proximal CRC, while FIT shows weaker risk reduction. However, the association between FIT exposure and CRC prevention strengthens as the frequency of cumulative FIT assessments increases.
INTRODUCTION: Use of colonoscopy or the fecal immunochemical test (FIT) for colorectal cancer (CRC) prevention is supported by previous studies. However, there is little specific evidence regarding comparative effectiveness of colonoscopy or FIT for reducing CRC risk. In this study, we compared the association of CRC risk with colonoscopy and FIT using a nationwide database. METHODS: This population-based case-control study used colonoscopy and FIT claims data from the Korean National Health Insurance System from 2002 to 2013. Data were analyzed from 61,221 patients with newly diagnosed CRC (case group) and 306,099 individuals without CRC (control group). Multivariable logistic regression models were used to evaluate the association between CRC and colonoscopy or FIT. RESULTS: Colonoscopy was associated with a reduced subsequent CRC risk (adjusted odds ratio [OR] 0.29). Stronger associations were found between colonoscopy and distal CRC, compared with proximal CRC (0.24 vs 0.47). In an analysis stratified by sex, the association was weaker in female subjects compared with male subjects (0.33 vs 0.27). Any FIT exposure was associated with CRC risk with an OR of 0.74; this association was stronger for distal cancer. As the frequency of cumulative FIT assessments increased (from 1 to >= 5), the OR of FIT exposure for CRC gradually decreased from 0.81 to 0.45. DISCUSSION: The association of colonoscopy or FIT with reduced CRC risk was stronger for distal CRC than for proximal CRC. FIT showed less CRC risk reduction than colonoscopy. However, as the frequency of cumulative FIT assessments increased, the association with CRC prevention became stronger.
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