林州市上消化道癌内窥镜筛查效果评价研究  

Evaluation of Screening for Upper Digestive Tract Cancer in Linzhou

作　　者：陈琼 于亮[3] 刘曙正[1] 郝长青 张萌[1] 王进武 张韶凯[1] 郭兰伟 全培良 孙喜斌 CHEN Qiong1,2 YU Liang3, LIU Shu-zheng1, et al.(1. Affiliated Cancer Hospital of Zhengzhou University,Henan Cancer Hospital,Zhengzhou 450008,China ;2. Shanxi Medical University Sc.hool of Public Health,Taiyuan 030001 ,China ; 3. Linzhou Cancer Hospital, Linzhou 456500, Chin)

机构地区：[1]郑州大学附属肿瘤医院、河南省肿瘤医院肿瘤防治研究办公室,河南郑州450008 [2]山西医科大学流行病与卫生统计学研究所,山西太原030001 [3]林州市肿瘤医院,河南林州456500

出　　处：《中国肿瘤》2018年第3期192-197,共6页China Cancer

基　　金：中央财政转移支付项目(2006BAl02A15)

摘　　要：[目的]利用肿瘤登记数据和上消化道癌症（食管癌和胃癌）筛查记录对人群筛查效果进行评价。[方法]选择林州市肿瘤登记处数据库中食管癌和胃癌死亡记录者为病例,随机选择5个与病例相同村庄、相同性别、年龄相差±2岁的存活村民作为对照,通过查询筛查档案获取病例和对照的筛查暴露信息。采用病例对照的研究方法,以内镜筛查为暴露因素,利用条件Logistic回归模型估计死亡风险比（OR）以及相应的95%可信区间（95%CI）。[结果 ]共有566例病例和2828例对照纳入统计分析。与从来没有参加筛查的人相比,筛查暴露者上消化道癌的死亡风险为0.65（95%CI：0.52-0.81）。筛查后时间〈2年、2-3年和4年及以上者上消化道癌的死亡风险分别为0.86（0.42-1.75）、0.60（0.40-0.89）、0.64（0.48-0.86）;筛查年龄〈50岁、50-59岁和60岁及以上者上消化道癌的死亡风险分别为0.64（0.32-1.70）、0.54（0.38-0.75）、0.76（0.56-1.04）。[结论 ]参加内窥镜筛查能够降低35%上消化道癌症的死亡风险,随着筛查后的时间增加以及筛查时年龄在50-59岁组能够增加死亡风险的降低幅度。[Purpose]To evaluate the effect of endoscopic screening for upper digestive tract cancer in Linzhou. [Methods] A case-control study was conducted to evaluate the effectiveness of screening for upper digestive tract cancer. Five hundred and sixty-six cases who died of gastric and esophageal cancer were collected from Linzhou Cancer Registry database and 2828 local residents matched by gender and age（±2 years） were selected as controls. Taking endoscopic screening as the exposure factor,the odds ratios（OR） and 95% confidence intervals（95% CI） were estimated by conditional logistic regression. [Results] Compared with subjects without screening,the overall OR of upper digestive tract cancer death for individuals with screening was 0.65（95%CI： 0.52-0.81）.The ORs for lag time of 2-3 years and 4 years were 0.60（0.40-0.89） and 0.64（0.48-0.86）,respectively. The OR for those aged 50-59 years was 0.54（0.38-0.75）. [Conclusion] The results suggest a 35% reduction in risk of upper digestive tract cancer mortality by endoscopic screening.

关 键 词：上消化道癌 死亡率 死亡风险 筛查 肿瘤登记 病例对照研究 河南 

分 类 号：R73-31[医药卫生—肿瘤]