上海市奉贤区社区居民大肠癌筛查结果分析  

Analysis on the result of screening colorectal cancer in residents in communities of Fengxian District in Shanghai

作　　者：罗卫平[1] 张琳[1] 张卫[1] 吴武鑫[1] 孙琪[1] 陈英[1] 汤海英[1] 

机构地区：[1]上海市奉贤区疾病预防控制中心慢性病防制科,上海201400

出　　处：《中国慢性病预防与控制》2015年第9期657-660,共4页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：上海市重大公共卫生服务项目(2013)

摘　　要：目的进行上海市奉贤区社区居民大肠癌筛查，探讨社区居民大肠癌筛查的效果。方法以《上海市重大公共卫生服务项目社区居民大肠癌筛查工作规范》为依据，对40～79岁上海市奉贤区户籍居民进行大肠癌筛查。以危险度评估问卷调查及粪便隐血试验（FOBT）作为初筛，初筛阳性者行全结肠镜检查，并对结果进行分析。结果实际筛查46501人，初筛阳性率为24．07％，无论男性还是女性，70岁以上人群初筛阳性率最高；肠镜检查依从率为45．90％，总病变检出率21．92％，总病变检出率随着年龄增长呈上升的趋势，不同年龄组总病变检出率比较，差异有统计学意义（x^2=21．25，P〈0．05），并且男性显著高于女性，差异有统计学意义（x^2=152．23，P〈0．05）；单一评估阳性组的肠镜检查依从率、总病变检出率、癌及癌前病变检出率分别为40．18％、16．41％和9．42％，均低于单一FOBT阳性组（分别为47．94％、23．06％和13．76％），差异均有统计学意义（P〈0．05）。结论危险度评估结合FOBT可以有效地检出上海市奉贤区居民大肠癌及癌前病变，对于降低大肠癌的死亡率和发病率具有重要意义。Objective To screen the colorectal cancer among residents in communities of Fengxian District and to assess the effects of the colorectal cancer screening among residents in communities. Methods According to ＂Work specification for colorectal cancer screening among community residents in the major community public health service program in Shanghai＂, the screening program of colorectal cancer was performed for residents with 40-79 years old in Fengxian District of Shanghai. The quantitative assessment questionnaire of risk factors and fecal occult blood tests （FOBT） were used to screen, the positive residents were examined with colonoscopy. All resuhs were analyzed. Results In fact, 46 501 residents were screened, the screening rate was 24.07%. The screening rate of residents with 〉 70 years old for females and males was the highest. The compliance rate of colonoscopy was 45.90%. The total detection rate of lesions was 21.92%, which increased with age （P〈0.05） and the male compliance rate of colonoscopy was significantly higher than female was much higher among males （P〈0.05）.The compliance rate of colonoscopy, total detection rate of lesions and detection rate of cancer and precancerous lesions in positive questionnaire group were 40.18%,16.42% and 9.42% respectively, which were significantly lower than those （47.92%,23.06% and 13.76% ） in positive FOBT group （P〈0.05）. Conclusion The risk assessment with FOBT can effectively detect the eolorectal cancer and precancerous lesions in residents of Fengxian District communities in Shanghai, which is important to decrease the morbidity and mortality of colorectal cancers.

关 键 词：大便隐血试验 大肠癌 筛查 依从率 社区居民 

分 类 号：R735.3[医药卫生—肿瘤]