日本基于人群的内镜胃癌筛查中癌症的偶然检出
Incidental detection of cancers during population-based endoscopic gastric cancer screening in Japan.
作者
作者单位
- Department of Otolaryngology-Head and Neck Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. pz6b2n7x@s.okayama-u.ac.jp.
- Department of Practical Gastrointestinal Endoscopy, Okayama University, Okayama, Japan.
- Department of Epidemiology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan.
- Department of Otolaryngology-Head and Neck Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
- Occupational Health Data Science Center, University of Occupational and Environmental Health, Kitakyushu, Japan.
摘要
中文
上消化道内窥镜检查与放射成像不同，它穿过整个上消化道，可能能够偶然检测非胃癌。然而，其对非胃上消化道癌症的人群层面偶然检出率尚未被系统量化。本研究旨在比较内镜筛查与放射筛查，并在基于人群的环境中量化非胃上消化道癌的检出。这项基于人群的队列研究通过将冈山市胃癌筛查登记册与Kokuho数据库（KDB）链接进行，覆盖2016-2021财年。在36,326名参与者贡献的64,822次筛查检查（40,832次放射成像；23,990次内镜）中，从KDB确定了筛查后2个月内发生的口腔、咽、喉和食管癌的诊断。使用广义估计方程和修正Poisson回归估计调整风险比（aRR），比较内镜与放射。内镜筛查与非胃上消化道癌的复合偶然检出率显著更高相关（95.9 vs 34.3 / 10万次检查；aRR 2.94，95%置信区间[CI] 1.50-5.76；p=0.002）。具体而言，食管癌检出率在内镜检查中显著更高（83.4 vs 17.1 / 10万次；aRR 5.16，95% CI 2.16-12.32；p<0.001）。口腔、咽或喉癌未观察到统计学显著差异。内镜胃癌筛查与非胃上消化道癌（尤其是食管癌）的偶然检出率显著升高相关。这些发现表明，在组织化筛查项目中，内镜的额外检出价值超出了其主要胃癌目标。
English
Upper gastrointestinal endoscopy traverses the full upper aerodigestive tract, unlike radiography, potentially enabling incidental detection of non-gastric malignancies. However, its population-level incidental detection rate for non-gastric upper aerodigestive tract cancers has not been systematically quantified. The aim of this study was to compare endoscopic screening with radiography and quantify detection of non-gastric upper aerodigestive tract cancers in a population-based setting. This population-based cohort study was conducted by linking the Okayama City municipal gastric cancer screening registry with the Kokuho Database (KDB) for fiscal years 2016-2021. Among 36,326 participants contributing 64,822 screening examinations (40,832 radiography; 23,990 endoscopy), diagnoses of oral cavity, pharyngeal, laryngeal, and esophageal cancer occurring within 2 months of screening were ascertained from the KDB. Generalized estimating equations with modified Poisson regression were used to estimate adjusted risk ratios (aRRs) comparing endoscopy with radiography. Endoscopic screening was significantly associated with higher composite incidental detection rates for non-gastric upper aerodigestive tract cancers (95.9 vs. 34.3 per 100,000 examinations; aRR 2.94, 95% confidence interval [CI] 1.50-5.76; p = 0.002). Specifically, esophageal cancer detection was markedly higher with endoscopy (83.4 vs. 17.1 per 100,000; aRR 5.16, 95% CI 2.16-12.32; p < 0.001). No statistically significant differences were observed for oral cavity, pharyngeal, or laryngeal cancers. Endoscopic gastric cancer screening is associated with substantially higher incidental detection of non-gastric upper aerodigestive tract cancers, particularly esophageal cancer. These findings suggest an additional detection value for endoscopy that extends beyond its primary gastric cancer target in organized screening programs.
分类与指标
- 研究类型
- 临床研究
- 病种
- 食管癌
- JCR 分区
- Q1
- 影响因子
- 5.8
- 新锐分区
- 4区