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).

项目摘要/摘要 结直肠癌（CRC）是美国与癌症相关死亡率的第二大最常见原因 （我们）。美国预防服务工作队已经建立了几种筛选模式，以提早发现 CRC，例如粪便免疫化学测试（FIT）和粪便血液检查（FOBT）。适合和FOBT是 美国使用的常见筛选工具。当异常时，拟合/FOBT必须随后进行诊断结肠镜检查 评估癌前和癌性结肠直肠病变。文献很少，结果多样 关于如何快速完成后续时间的建议。研究表明了一个最佳窗口 诊断随访时间从异常拟合/FOBT之后的6个月到24个月的建议变化。 此外，研究主要来自台湾和以色列的国际人口。目前，只有 一项研究研究诊断性结肠镜检查和结直肠癌的时间的影响。仅此研究 查看CRC的发生率和诊断阶段，而不是CRC死亡率。此外，研究人群是 仅限于加利福尼亚州。总体而言，未能完成诊断结肠镜检查之间的关系 在异常拟合/FOBT之后，在CRC结果上尚未广泛研究。我们的研究将使用国家 电子健康记录和退伍军人事务部（VA）的基于索赔的数据，以解决关键 通过评估诊断性色膜和多个CRC终点之间的关系，通过评估文献中的差距。 首先，我们将研究暴露与未暴露的个体中发生事件和致命CRC癌的风险 在异常拟合/FOBT之后进行诊断结肠镜检查（AIM 1）。接下来，我们将确定时间的影响 结肠镜检查，暴露于诊断性结肠镜检查的个体中，CRC发病率，诊断时期， 和致命癌（AIM 2）。最后，我们将表征社会人口统计学和临床​​的程度 变量（例如Charlson合并症，年龄，种族）在异常拟合/FOBT之后诊断完成 筛选测试（AIM 3）。