Abnormal Fecal Test Results Associated with Colorectal Cancer Incidence and Mortality

粪便检测结果异常与结直肠癌发病率和死亡率相关

• 批准号: 10063801
• 负责人: Samir Gupta
• 金额: $ 7.74万
• 依托单位: VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-02-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10063801
• 关键词: Address; Advisory Committees; Age; California; Cancer Etiology; Cancerous; Clinical; Cohort Studies; Colonoscopy; Colorectal; Colorectal Cancer; Data; Diagnosis; Diagnostic; Electronic Health Record; Exposure to; Failure; Fecal occult blood; Incidence; Individual; Institutes; International; Israel; Lesion; Literature; Malignant Neoplasms; Methods; Outcome; Polypectomy; Population; Preventive service; Race; Recommendation; Risk; Screening procedure; Stage at Diagnosis; Taiwan; Test Result; Testing; Time; United States; Veterans; aged; base; cohort; colorectal cancer risk; colorectal cancer screening; comorbidity; early screening; follow-up; mortality; parent grant; premalignant; screening; sociodemographics; study population; time interval

PROJECT SUMMARY/ABSTRACT Colorectal cancer (CRC) is the second most common cause of cancer-related mortality in the United States (US). The US Preventive Services Task Force has instituted several modes of screening for early detection of CRC, such as the fecal immunochemical test (FIT) and fecal occult blood tests (FOBT). FIT and FOBT are common screening tool used in the US. FIT/FOBT must be followed by diagnostic colonoscopy when abnormal to evaluate for precancerous and cancerous colorectal lesions. The literature is scarce and has varied results on recommendations for how quickly to complete follow-up time. Studies suggesting an optimal window for diagnostic follow-up vary their recommendations from 6 months to 24 months after abnormal FIT/FOBT. Additionally, studies mainly came from international populations in Taiwan and Israel. Currently, there was only one US study examining the effect of time to diagnostic colonoscopy and colorectal outcomes. This study only looked at CRC incidence and stage of diagnosis, and not CRC mortality. Additionally, the study population was limited to the state of California. Overall, the relationship between failure to complete diagnostic colonoscopy after an abnormal FIT/FOBT on CRC outcomes has not been widely studied. Our study will use national electronic health records and claims-based data from the Department of Veterans Affairs (VA) to address key gaps in the literature by evaluating the relationship between diagnostic coloscopy and multiple CRC endpoints. First, we will examine the risk for incident and fatal CRC cancer among individuals exposed versus unexposed to diagnostic colonoscopy after abnormal FIT/FOBT (Aim 1). Next, we will determine the effect of time to colonoscopy, among individuals exposed to diagnostic colonoscopy, on CRC incidence, stage at diagnosis, and fatal cancer (Aim 2). Lastly, we will characterize the extent to which sociodemographic and clinical variables (e.g. Charlson comorbidity, age, race) impact diagnostic completion after an abnormal FIT/FOBT screening test (Aim 3).

项目概要/摘要 结直肠癌 (CRC) 是美国癌症相关死亡的第二大常见原因 （我们）。美国预防服务工作组制定了多种筛查模式，以尽早发现 CRC，如粪便免疫化学试验（FIT）和粪便潜血试验（FOBT）。 FIT 和 FOBT 是 美国常用的筛查工具。当异常时，FIT/FOBT 必须随后进行诊断性结肠镜检查 评估癌前病变和癌性结直肠病变。文献稀少且结果各异 关于多快完成跟进时间的建议。研究表明最佳窗口期 诊断随访的建议从异常 FIT/FOBT 后 6 个月到 24 个月不等。 此外，研究主要来自台湾和以色列的国际人群。目前，只有 美国的一项研究考察了时间对诊断性结肠镜检查和结直肠结果的影响。仅此研究 研究了结直肠癌的发病率和诊断阶段，而不是结直肠癌死亡率。此外，研究人群是 仅限于加利福尼亚州。总体而言，未能完成诊断性结肠镜检查与 异常 FIT/FOBT 对 CRC 结果的影响尚未得到广泛研究。我们的研究将使用国家 来自退伍军人事务部 (VA) 的电子健康记录和基于索赔的数据，以解决关键问题 通过评估诊断性结肠镜检查与多个 CRC 终点之间的关系来弥补文献中的空白。 首先，我们将检查接触过的个体与未接触过的个体发生事故和致命性结直肠癌的风险 FIT/FOBT 异常后进行诊断性结肠镜检查（目标 1）。接下来，我们将确定时间的影响 结肠镜检查，在接受诊断性结肠镜检查的个体中，关于结直肠癌的发病率、诊断分期、 和致命的癌症（目标 2）。最后，我们将描述社会人口学和临床的程度 变量（例如 Charlson 合并症、年龄、种族）影响异常 FIT/FOBT 后的诊断完成 筛选测试（目标 3）。