筛查检测到的结直肠癌 (CRC) 的治疗方法通常比阶段匹配的非筛查检测到的 CRC 的侵入性较小，但其原因尚不完全清楚。这项研究评估了荷兰筛查项目内外检测到的 I 期 CRC 的治疗情况。方法 ：分析了荷兰癌症登记处2008年1月1日至2020年12月31日期间诊断的所有I期CRC的数据，比较了筛查检测和非筛查检测的I期CRC的患者、肿瘤和治疗特征。使用多变量逻辑回归来评估治疗（仅局部切除与肿瘤手术切除）与患者和肿瘤特征之间的关联，并按 T 分期和肿瘤位置进行分层。与非筛查检测的 I 期 CRC 相比，筛查检测的 I 期 CRC 的 T1 期相对较多（66.9 % vs. 53.3 %；P < 0.001）。当仅考虑 T1 肿瘤时，筛查检测到的结肠癌和直肠癌比非筛查检测到的 T1 癌症更常仅采用局部切除治疗（比值比 [OR] 2.19，95 % CI 1.93-2.49；OR 1.29， 95 %CI 分别为 1.05-1.59），根据性别、肿瘤位置、淋巴管侵犯 (LVI) 状态和肿瘤分化进行调整。结论 ：与非筛查检测的 I 期 CRC 相比，T1 期癌症的发病率较高，部分解释了筛查检测的 I 期 CRC 的侵入性较小的治疗。根据 LVI 和肿瘤分化等危险因素进行调整后，经筛查检测到的 T1 期 CRC 也比未经筛查检测到的 CRC 更有可能接受侵入性较小的治疗。未来的研究应该调查局部切除的选择是否与未确定的癌症相关因素或内窥镜医师的专业知识有关。作者。这是 Thieme 根据知识共享署名许可条款发表的开放获取文章，只要正确引用原始作品，就允许不受限制地使用、分发和复制。 （https://creativecommons.org/licenses/by/4.0/）。

 Screen-detected colorectal cancers (CRCs) are often treated less invasively than stage-matched non-screen-detected CRCs, but the reasons for this are not fully understood. This study evaluated the treatment of stage I CRCs detected within and outside of the screening program in the Netherlands. METHODS : Data from the Netherlands Cancer Registry for all stage I CRCs diagnosed between January 1, 2008 and December 31, 2020 were analyzed, comparing patient, tumor, and treatment characteristics of screen-detected and non-screen-detected stage I CRCs. Multivariable logistic regression was used to assess the association between treatment (local excision only vs. surgical oncologic resection) and patient and tumor characteristics, stratified for T stage and tumor location. Screen-detected stage I CRCs were relatively more often T1 than T2 compared with non-screen-detected stage I CRCs (66.9 % vs. 53.3 %; P < 0.001). When only T1 tumors were considered, both screen-detected colon and rectal cancers were more often treated with local excision only than non-screen-detected T1 cancers (odds ratio [OR] 2.19, 95 %CI 1.93-2.49; and OR 1.29, 95 %CI 1.05-1.59, respectively), adjusted for sex, tumor location, lymphovascular invasion (LVI) status, and tumor differentiation. CONCLUSIONS : Less invasive treatment of screen-detected stage I CRC is partly explained by the higher rate of T1 cancers compared with non-screen-detected stage I CRCs. T1 stage I screen-detected CRCs were also more likely to undergo less invasive treatment than non-screen-detected CRCs, adjusted for risk factors such as LVI and tumor differentiation. Future research should investigate whether the choice of local excision was related to unidentified cancer-related factors or the expertise of the endoscopists.The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).