The objective of this study is to evaluate interval cancer (IC) in colorectal cancer (CRC) screening, which is CRC diagnosed in an individual after having received a negative faecal occult blood test and before the next invitation to participate in screening. A follow-up study was conducted on a cohort of participants in the first three screening rounds of four colorectal cancer screening programmes in Spain,n= 664,993. A total of 321 ICs and 2120 screen-detected cancers (SCs) were found. The IC and SC rates were calculated for each guaiac (gFOBT) or immunochemical (FIT) test. A Cox regression model was used to estimate the hazard ratios (HR) of IC risk factors. A nested case–control study was carried out to compare IC and SC tumour characteristics. The IC rate was 1.16‰ with the gFOBT and 0.35‰ with the FIT. Men and people aged 60–69 showed an increased probability of IC (HR = 1.81 and HR = 1.95, respectively). There was a decreased probability of IC in individuals who regularly participated in screening, HR = 0.62 (0.47–0.82). IC risk gradually rose as the amount of Hb detected in the FIT increased. IC tumours were in more advanced stages and of a larger size than SC tumours, and they were mostly located in the cecum. These results may play a key role in future strategies for screening programmes, reducing IC incidence.
本研究旨在评估结直肠癌筛查中的间期癌，即个体在接受粪便隐血试验呈阴性后、至下一次筛查邀请前被诊断出的结直肠癌。研究对西班牙四项结直肠癌筛查项目前三轮筛查的参与者队列（n=664,993）进行了随访。共发现321例间期癌和2120例筛查检出癌。分别计算了愈创木脂法粪便隐血试验和免疫化学法粪便隐血试验的间期癌与筛查检出癌发生率。采用Cox回归模型评估间期癌风险因素的风险比，并通过巢式病例对照研究比较间期癌与筛查检出癌的肿瘤特征。结果显示：愈创木脂法检测的间期癌发生率为1.16‰，免疫化学法为0.35‰。男性及60-69岁人群的间期癌发生风险显著增高（风险比分别为1.81和1.95）。规律参与筛查者的间期癌风险降低，风险比为0.62（0.47-0.82）。免疫化学法检测中血红蛋白浓度越高，间期癌风险呈渐进性上升。与筛查检出癌相比，间期癌肿瘤分期更晚、体积更大，且多位于盲肠。这些发现可为未来优化筛查策略、降低间期癌发生率提供关键依据。
肿瘤(癌症)患者之家