“序贯粪隐血大肠肿瘤筛检方案”应用价值的再探讨  

Reassessment on the screening program of colorectal cancer by the “sequential fecal occult blood test”

作　　者：北京地区大肠肿瘤普查协作组 

出　　处：《中华消化杂志》2002年第7期395-397,共3页Chinese Journal of Digestion

摘　　要：目的　通过自然人群大肠肿瘤普查了解近年北京市大肠癌发病情况 ,进一步探讨“序贯粪便隐血大肠癌筛检方案”的有效性和可行性。方法　选定 15家医院医疗责任区内 4 810 0自然人群为本次普查靶人群。对其中 30岁以上的社区居民或企业职工 2 6 82 7人进行普查登记 ,并连续进行 3d序贯粪隐血检查。隐血阳性者接受结肠镜检查。符合高危条件者 ,全部接受隐血和肠镜检查。结果　预计普查人数为 2 6 82 7人 ,实际普查人数为 1985 2人 ,普查率为 74 %。男女比例为 1.0 5∶1。中位年龄 5 0岁。序贯粪隐血阳性率为 5 .6 %。检出大肠癌 12例 ,其中DukesA期 4例 ,B期 7例 ,C期 1例。DukesA +B共 11例 ,占全部检出癌的 91.6 6 %。 4 0岁以下人群未检出大肠癌 ,5 0岁以上人群中 ,检出大肠癌的比例随年龄升高而逐渐增加。高危人群中检出 2例大肠癌 ,占该人群的 0 .2 8% ,一般危险人群中检出 10例大肠癌 ,占该人群的 0 .0 5 %。结论　普查靶人群的大肠癌患病率为 36 .5 7/ 10 5,提示北京市城区有较高的患病率。采用“序贯粪隐血筛检方案”检出了 91.6 6 %的早期和较早期癌 ,提示该方案的有效性和可行性。高危人群和 5Objective To estimate the prevalence of colorectal cancer in Beijing area, the efficacy and feasibility of “sequential fecal occult blood test (SFOBT) program” on the screening of colorectal cancer. Methods SFOBT and colonoscopy screening programs were applied to 26 827 subjects aged 30-91 years, at a participation rate of 74%. Results The positivity rate of SFOBT was 5.6% . Twelve cases of colorectal cancer were detected in the population. Among them, 4 cases was in Dukes A stage, 7 in Dukes B, and 1 in Dukes C. The estimated prevalence of colorectal cancer in the population was 36.57 /10 5. No colorectal cancer was detected in population under 40 years old, and 2 cases in subjects aged 51-60 years ( 0.04% ), 2 cases in 61-70 years ( 0.06% ), 4 cases in 61-70 years ( 0.09% ), 3 cases in 71-80 years (0.146%) , 1 case in 81-90 years ( 0.49% ). Two cases were found in high risk population ( 0.28% ), and 10 cases in general population ( 0.05% ). Conclusions The prevalence of colorectal cancer was high in Beijing area. Most cases ( 91.66% ) were detected as “curable cancer” by screening. It suggested that “SFOBT program” was effective and feasible for screening of colorectal cancer. High risk and over 50 years old population were key subjects for the screening.

关 键 词：大肠肿瘤 疾病普查 序贯粪隐血试验 诊断 大肠癌 

分 类 号：R735.34[医药卫生—肿瘤]