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Effect of Colonoscopy Outreach vs Fecal Immunochemical Test Outreach on Colorectal Cancer Screening Completion: A Randomized Clinical Trial.
结肠镜检查外展与粪便免疫化学试验外展对结直肠癌筛查完成的影响: 一项随机临床试验。

摘要

Importance:Mailed fecal immunochemical test (FIT) outreach is more effective than colonoscopy outreach for increasing 1-time colorectal cancer (CRC) screening, but long-term effectiveness may need repeat testing and timely follow-up for abnormal results.
Objective:Compare the effectiveness of FIT outreach and colonoscopy outreach to increase completion of the CRC screening process (screening initiation and follow-up) within 3 years.
Design, Setting, and Participants:Pragmatic randomized clinical trial from March 2013 to July 2016 among 5999 participants aged 50 to 64 years who were receiving primary care in Parkland Health and Hospital System and were not up to date with CRC screenings.
Interventions:Random assignment to mailed FIT outreach (n = 2400), mailed colonoscopy outreach (n = 2400), or usual care with clinic-based screening (n = 1199). Outreach included processes to promote repeat annual testing for individuals in the FIT outreach group with normal results and completion of diagnostic and screening colonoscopy for those with an abnormal FIT result or assigned to colonoscopy outreach.
Main Outcomes and Measures:Primary outcome was screening process completion, defined as adherence to colonoscopy completion, annual testing for a normal FIT result, diagnostic colonoscopy for an abnormal FIT result, or treatment evaluation if CRC was detected. Secondary outcomes included detection of any adenoma or advanced neoplasia (including CRC) and screening-related harms (including bleeding or perforation).
Results:All 5999 participants (median age, 56 years; women, 61.9%) were included in the intention-to-screen analyses. Screening process completion was 38.4% in the colonoscopy outreach group, 28.0% in the FIT outreach group, and 10.7% in the usual care group. Compared with the usual care group, between-group differences for completion were higher for both outreach groups (27.7% [95% CI, 25.1% to 30.4%] for the colonoscopy outreach group; 17.3% [95% CI, 14.8% to 19.8%] for FIT outreach group), and highest in the colonoscopy outreach group (10.4% [95% CI, 7.8% to 13.1%] for the colonoscopy outreach group vs FIT outreach group; P 

译文

重要性: 邮寄粪便免疫化学测试 (FIT) 外展比结肠镜外展更有效,可以增加一次结直肠癌 (CRC) 筛查, 但是长期有效性可能需要重复测试和对异常结果的及时随访。
目的: 比较 FIT 外展和结肠镜外展的有效性,以在 3 年内提高 CRC 筛查过程 (筛查启动和随访) 的完成。
设计、设置和参与者: 从 2013年3月到 2016年7月,在 5999 名年龄在 50 岁到 64 岁之间的参与者中进行了务实的随机临床试验,这些参与者在帕克兰健康和医院系统接受初级保健,并且没有及时进行 CRC 筛查。
干预: 随机分配邮寄健康外展 (n = 2400),邮寄结肠镜外展 (n = 2400),或基于临床筛查的常规护理 (n = 1199)。外展包括促进 FIT 外展组中具有正常结果的个人进行重复年度测试的过程,以及为那些具有异常 FIT 结果或被分配到结肠镜外展的人完成诊断和筛查结肠镜检查的过程。
主要结果和措施: 主要结果是完成筛选过程,定义为坚持结肠镜检查完成,每年测试一个正常匹配结果,诊断结肠镜检查异常匹配结果, 或者如果检测到 CRC,则进行治疗评估。次要结果包括检测任何腺瘤或晚期肿瘤 (包括 CRC) 和筛查相关危害 (包括出血或穿孔)。
结果: 所有 5999 名参与者 (平均年龄 56 岁; 女性,61.9%) 都被纳入意向筛选分析。结肠镜外展组的筛查过程完成率为 38.4%,FIT 外展组为 28.0%,常规护理组为 10.7%。与常规护理组相比,两组外展组完成的组间差异较高 (结肠镜外展组为 27.7% [95% CI,25.1% 至 30.4%]; 17.3% [95% CI, 14.8% 到 19.8%] 对于 FIT 外展组),在结肠镜外展组中最高 (10.4% [95% CI,7.8% 到 13.1%] 用于结肠镜检查外展组与 FIT 外展组; p

fecal immunochemical test

肿瘤 结肠癌 诊断方式
概述  :  

粪便免疫化学测试(FIT)是一种早期结肠癌筛查程序,能够准确的检测粪便中是否出血,而这通常是癌症的一个早期征象,如果检测结果为阴性,那么患者不再需要进行结肠镜检查。而且患者可以保留隐私,在家中采集样品。FIT结肠癌筛查参与者可以寄送粪便样本至检测中心,然后接收FIT筛查结果。粪便免疫化学试验,由美国预防服务工作组认可,在美国成为越来越普遍的大肠癌筛查方法。有研究结果显示,粪便免疫化学试验阳性后,与那些在一个月内即接受随访结肠镜检查的患者相比,等待10个多月后才接受结肠镜检查的患者结直肠癌(C


Fecal   英 /'fiːkəl/   美 /'fikəl/

释    义   adj. 排泄物的;残渣的;糟粕的

例    句   Fecal Occult Blood test Every year to detect hidden blood in the stool, a possible sign of colon cancer. 粪便潜血检验每年一次,以检查粪便中是否潜血,粪便潜血是结肠癌的可能徵兆。

 

Immunochemical   英 /,ɪmjʊnəʊ'kemɪkəl/

释    义   adj. 免疫化学的

同根词   immune adj. 免疫的;免于……的,免除的

               immunized adj. 免疫的

               immunocompetent adj. 免疫活性的

               immunogenic adj. 产生免疫性的;

               immune n.免疫者;免除者

               immunity n. 免疫力;豁免权;免除

               immunization n. 免疫

               immunodeficiency n. [免疫] 免疫缺陷

               immunisation n. 免疫;免疫法

               immunoglobulin n. [免疫][生化] 免疫球蛋白;免疫血球素

               immunoassay n. 免疫分析,免疫测定

               immunochemistry n. 免疫化学

               immunocompetence n. 免疫能力;免疫活性

               immunoelectrophoresis n. [临床] 免疫电泳

               immunofluorescence n. [免疫] 免疫荧光;萤光免疫检验法

               immunogen n. [免疫] 免疫原

               immunogenicity n. [免疫] 免疫原性;致免疫性;致免疫力;

例    句   Conclusion: The condition of children with HLH can be effectively control early with immunochemical therapy of HLH-04 protocol. 结论:儿童HLH可通过采用HLH-04方案的免疫化学治疗,早期得以有效控制。

 

Test   英 /test/

释    义   n. 测验,考查;测试;检验;化验;v. 测验;化验,检查;试验,测试;考验

例    句   Why do we have to do durability test? 我们为什么要做耐久性测试?

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