上海市闵行区“六癌”早发现效果及影响因素分析  

An Analysis of the Effect and Impacting Factors in Early Detecting for “Six Types Cancers” in Minhang District, Shangshai

作　　者：何丹丹[1] 赵燕萍[1] 方红[1] 苏华林[1] 白庆瑞[2] 周洁[1] 赵立昀[1] 严玉洁[1] 

机构地区：[1]上海市闵行区疾病预防控制中心,上海201101 [2]上海市疾病预防控制中心,上海200336

出　　处：《中国肿瘤》2014年第2期118-123,共6页China Cancer

基　　金：闵行区自然科学基金(2011MHZ53)

摘　　要：[目的]了解闵行区＂六癌＂（大肠癌、胃癌、肝癌、肺癌、乳腺癌、宫颈癌）早发现效果及其影响因素。[方法]对1999~2011年早发现登记队列中确诊的＂六癌＂与肿瘤登记系统中同期非队列人群确诊的＂六癌＂确诊期别、生存率及生存质量进行比较。[结果]＂六癌＂早期率,1年、3年、5年生存率和生存质量队列组均优于非队列组。基于社区的早发现模式效果好于基于医疗机构的早发现模式。影响患者生存的因素为：发病年龄、性别、家族史、手术性质、转移、患≥2个肿瘤、未经早发现干预,OR分别为：1.03、1.13、2.17、1.21、1.88、1.76、1.71。粘液性囊性肿瘤风险较高（OR=1.22,P=0.02）,腺癌、导管癌及鳞癌与上皮肿瘤相比死亡风险相当。患肠癌、胃癌、肝癌及肺癌较宫颈癌的死亡风险分别为：1.55、2.55、3.99、4.07,乳腺癌为宫颈癌死亡风险的0.66倍。[结论]两种早发现模式均有一定成效,基于社区的肿瘤早发现模式效果较优。＂六癌＂早发现、早诊断、早治疗,提高根治率是降低死亡风险的关键,尤其需要加强肝癌及肺癌的早诊早治工作。[Purpose] To investigate the effect of ＂six types cancers＂ （cancers of colorectum,stom- ach,liver,lung,breast and cervical） early detection and its impacting factors in Minhang district. [ Method ] The stages, survival and QOL between queue and non-queued groups from 1999 to 2011 were compared. [Resuhs] The early detection rate,survival rate of 1-year,3-year and 5-year and QOL of ＂six types cancers＂ in queue group were better than those in non-queue group. The effect of early detection in community-based mode was better than that in medical institutions based mode. Factors impacting survival of cancer patients were age ,male ,family history ,surgical ,multiple tumor,delayed early detection and delayed intervention,with OR of 1.03,1.13,2.17,1.21,1.88,1.76, 1.71 respectively.Compared with cervical cancer,in colorectum,stomach cancer,liver cancer and lung cancer was 1.55,2.55,3.99,and 4.07,respectively. The mortality risk of breast cancer was 0.66 times of cervical cancer. [Conclusion] Two early detection modes are all effective. Communi- ty-based early detection model is much better. Early detection,early diagnosis,early treatment and improving the cure rate are the keys to reduce the risk of death, especially the early detection and treatment for liver cancer and lung cancer should be strengthened.

关 键 词：恶性肿瘤 早发现 生存率 影响因素 

分 类 号：R73-31[医药卫生—肿瘤]