Screening participants with inflammatory bowel disease or high colorectal cancer risk in Denmark: a cohort study.

IF 2.3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of Public Health Policy Pub Date : 2024-10-16 DOI:10.1057/s41271-024-00523-z

Signe Bülow Therkildsen, Pernille Thordal Larsen, Sisse Helle Njor

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Abstract

Individuals with inflammatory bowel disease (IBC) and high-risk individuals are advised to discuss participation with their doctor and not to participate in colorectal cancer (CRC) screening. Yet a substantial proportion still participate in the Danish faecal immunochemical test (FIT) screening and have a higher positive FIT rate than the average-risk population. We estimated the risk of false-positive screening among individuals with inflammatory bowel disease and high-risk individuals to improve recommendations regarding screening participation. We included 71,871 FIT-positive participants (2014-2017) who had a subsequent colonoscopy within 3 months. Screening outcome within 180 days was established by using registers. We determined that 26,591 of the included participants had a false-positive screening. Participants with IBC or high CRC risk had a significantly higher risk of getting a false-positive screening than the average risk population, resulting in too many screening-related colonoscopies being performed among these individuals, indicating a need to update the screening protocols.

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丹麦炎症性肠病或结肠直肠癌高危人群筛查：一项队列研究。

炎症性肠病（IBC）患者和高危人群被建议与医生讨论是否参加筛查，不要参加结直肠癌（CRC）筛查。然而，仍有相当一部分人参加了丹麦粪便免疫化学检验（FIT）筛查，而且其 FIT 阳性率高于平均风险人群。我们估算了炎症性肠病患者和高危人群中筛查假阳性的风险，以改进筛查参与建议。我们纳入了 71871 名在 3 个月内接受后续结肠镜检查的 FIT 阳性参与者（2014-2017 年）。通过登记册确定了 180 天内的筛查结果。我们确定，在纳入的参与者中，有 26,591 人的筛查结果为假阳性。患有 IBC 或高 CRC 风险的参与者获得假阳性筛查的风险明显高于普通风险人群，导致在这些人群中进行了过多与筛查相关的结肠镜检查，这表明有必要更新筛查方案。

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来源期刊

Journal of Public Health Policy 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.70

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Public Health Policy (JPHP) will continue its 35 year tradition: an accessible source of scholarly articles on the epidemiologic and social foundations of public health policy, rigorously edited, and progressive. JPHP aims to create a more inclusive public health policy dialogue, within nations and among them. It broadens public health policy debates beyond the ''health system'' to examine all forces and environments that impinge on the health of populations. It provides an exciting platform for airing controversy and framing policy debates - honing policies to solve new problems and unresolved old ones. JPHP welcomes unsolicited original scientific and policy contributions on all public health topics. New authors are particularly encouraged to enter debates about how to improve the health of populations and reduce health disparities.