2013—2016年上海市浦东新区某社区大肠癌筛查结果分析  

Results of colorectal cancer screening in a community of Pudong New Area of Shanghai from 2013 to 2016

作　　者：李娟萍 李小攀 郑晶泉[3] 刘峥[1] 杨琛 杨郗[1] 

机构地区：[1]上海市浦东新区东明社区卫生服务中心预防保健科,上海200123 [2]复旦大学公共卫生学院公共卫生安全教育部重点实验室,上海200032 [3]上海市浦东新区疾病预防控制中心复旦大学浦东新区预防医学研究院,上海200136

出　　处：《上海预防医学》2018年第2期111-114,125,共5页Shanghai Journal of Preventive Medicine

基　　金：上海市浦东新区优秀社区适宜人才项目(PWRs2016-17);上海市卫生和计划生育委员会科研课题面上项目(201540407);上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2017-33);上海市浦东新区卫生系统重点学科建设(PWZxk2017-28)

摘　　要：【目的】分析2013—2016年上海浦东新区东明社区大肠癌筛查结果,为优化社区居民大肠癌筛查策略提供参考。【方法】采用填写危险度评估表结合粪便隐血试验(FOBT)的两步筛查法,对2013—2016年东明社区居民大肠癌筛查结果进行分析。【结果】共完成初筛13 669人,初筛完成率为99.63%,初筛阳性率为30.84%;其中849人参加肠镜检查,肠镜依从率为20.14%,大肠癌检出率为1.18%,管状腺瘤检出率为3.18%,总病变检出率为15.43%,单纯危险度评估阳性者肠镜依从性低于单纯粪便隐血检测阳性者、危险度评估和粪便隐血均阳性者,差异有统计学意义(χ2=170.32,P<0.001);总病变检出率男性高于女性,差异有统计学意义(χ2=10.03,P<0.05);目标人群(50~74岁)病变检出率高于非目标人群(<50或>74岁),差异有统计学意义(χ2=48.28,P<0.001)。【结论】大肠癌筛查效果明显,但肠镜参与率等指标偏低,提高肠镜参与率的措施尚需进一步优化。[Objective] To analyze the colorectal cancer screening results in Dongming Community of Pudong New Area of Shanghai,providing a reference for community screening. [Methods] The residents receiving colorectal cancer screening in Dongming Community were recruited from 2013 to 2016,who were required to fill in risk assessment form and go through fecal occult blood test（ FOBT）. The results obtained were analyzed. [Results] A total of 13 669 people completed preliminary colorectal cancer screening,completion rate being 99. 36% and preliminary screening positive rate 30. 84%,of whom 849 participated in colonoscopy. Enteroscope compliance rate was 20. 14%; colorectsl cancer detection rate 1. 18%;tubular adenoma detection rate 3. 18%, The total lesion detection rate was 15. 43%. For those with simple positive risk assessment, their enteroscope compliance was lower than those with pure positive FOBT or with both positive risk assessment and FOBT. The differences between them were of statistical significance（ χ^2= 170. 32, P〈0. 001）. The total lesion detection rate was higher in males than in females with statistical differeces（ χ^2= 10. 03,P〈0. 05）; the lesion detection rate was higher in target population（ aged 50-74） than in non-target（ ages〈 50 or 〉74） with statistical differences（ χ^2= 48. 28,P〈0. 001）. [Conclusion] The effect of colorectal cancer screening is significant,but the participation rate of colonoscopy slightly lower,and the measures related to the rate of colonoscopy need to be further improved.

关 键 词：结直肠癌 筛查 社区 粪便隐血试验 肠镜 

分 类 号：R739.63[医药卫生—肿瘤]