背景

一些专业协会推荐对结直肠癌(CRC)幸存者进行治疗后监测。本研究显示了长时间的监测结果，特别着重于不同种族之间监测结果的差别，另外还研究了地区特点如CRC筛查能力在监测中的作用。

方法：

监测，流行病学和最终结果(Surveillance, Epidemiology, and End Results, SEER)医疗数据被用于确定在1993至2005年间，年龄为66-85岁且被诊断为CRC并进行手术治疗的患者。该研究调查了与术后接受结肠镜检查、癌胚抗原(CEA)检测、初级保健(PC)就诊以及进行含综合衡量措施全面监控的相关因素。

结果

在进入监测的对象中，61.0%进行了肠镜检查，68.0%患者进行了CEA检测，77.1%的患者进行了PC访问，而有43.0%的患者进行了整体监测。经过调整后我们发现，黑种人比白种人更少接受肠镜检查[比值比(OR)0.76, 95%可信区间(CI)=0.69-0.83]，CEA监测和整体监测，但是白种人和西班牙籍之间无差别。从1993年到2005年，所有预后的比率增加，但是在黑种人/白种人之间存在差别。具有最高能力进行CRC筛查的地区，患者更有可能接受肠镜检查(OR = 1.09, 95% CI = 1.02-1.18)，而在黑种人比率最高的地区接受肠镜检查的比率则较低(OR = 0.89, 95% CI = 0.83-0.95)。生活在无PC地区的患者较少接受PC访问(OR = 0.55, 95% CI = 0.48-0.64)和整体监测(OR = 0.83, 95% CI = 0.71-0.98)。

结论：

许多CRC幸存者都没有进行推荐的监测，黑种人/白种人的监测比率没有获得改善。个体所居住的地方特征可影响监测的使用。

期刊：《Cancer》

原文：

Surveillance after resection for colorectal cancer

Phyllis Brawarsky MPH, Bridget A. Neville MPH, Garrett M. Fitzmaurice ScD, et al

Ab:

BACKGROUND:

Professional societies recommend posttreatment surveillance for colorectal cancer (CRC) survivors. This study describes the use of surveillance over time, with a particular focus on racial/ethnic disparities, and also examines the role of area characteristics, such as capacity for CRC screening, on surveillance.

METHODS:

Surveillance, Epidemiology, and End Results (SEER)-Medicare data were used to identify individuals aged 66 to 85 years who were diagnosed with CRC from 1993 to 2005 and treated with surgery. The study examined factors associated with subsequent receipt of a colonoscopy, carcinoembryonic antigen (CEA) testing, primary care (PC) visits, and a composite measure of overall surveillance.

RESULTS:

Of eligible subjects, 61.0% had a colonoscopy, 68.0% had CEA testing, 77.1% had PC visits, and 43.0% received overall surveillance. After adjustment, blacks were less likely than whites to undergo colonoscopy (odds ratio [OR] 0.76, 95% confidence interval [CI] = 0.69-0.83) and to receive CEA testing and overall surveillance, whereas white/Hispanic rates did not differ. Rates for all outcomes increased from 1993 to 2005, but black/white disparities remained. Individuals in areas with greatest capacity for CRC screening were more likely (OR = 1.09, 95% CI = 1.02-1.18) to receive colonoscopy, and those in areas with the greatest percentage of blacks were less likely (OR = 0.89, 95% CI = 0.83-0.95) to receive colonoscopy. Those living in areas with shortage of PC were less likely to receive PC visits (OR = 0.55, 95% CI = 0.48-0.64) and overall surveillance (OR = 0.83, 95% CI = 0.71-0.98).

CONCLUSIONS:

Many CRC survivors do not get recommended surveillance, and black/white disparities in rates of surveillance have not improved. Characteristics of the area where an individual lives contribute to the use of surveillance. Cancer 2013

Cancer

March 2013

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