胃肠道恶性肿瘤家族史结直肠癌患者延诊现状分析  

Analysis of health-seeking delay in colorectal cancer patients with gastrointestinal malignant tumor family history

作　　者：吴晓丹[1] 蔡娟 税敏 邓杨 田亚杰 覃惠英[4] 丘雪 郑美春[1] WU Xiao-dan;CAI Juan;SHUI Min;DENG Yang;TIAN Ya-jie;QIN Hui-ying;QIU Xue;ZHENG Mei-chun(Sun Yat-sen University Cancer Center ,Guangzhou 510060 ,P. R. China;Department of Oncology ＆ Hematologic ,Chongqing General Hospital ,Chongqing 400014 ,P. R. China;School of Nursing, Sun Yat-sen University, Guangzhou 510080, P. R. China)

机构地区：[1]中山大学肿瘤防治中心结直肠科,广东广州510060 [2]重庆市人民医院肿瘤血液科,重庆400014 [3]中山大学护理学院,广东广州510080 [4]中山大学肿瘤防治中心护理部,广东广州510060

出　　处：《中华肿瘤防治杂志》2018年第4期221-225,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：2015年广东省科技发展专项资金(2014A020212105);2016年广东省科技发展专项资金(2016A020215091)

摘　　要：目的积极治疗癌前病变、早诊早治是预防和治愈结直肠癌的关键,对于家族史阳性的人群更是如此,关于家族史阳性的结直肠癌患者既往肠癌筛查率和就诊延误等情况的研究尚不多见。本研究拟调查胃肠道恶性肿瘤家族史阳性的结直肠癌患者就诊延误的现状并分析其影响因素,为结直肠癌的防治及临床健康教育干预提供理论依据。方法选取2016-01-01-2016-12-31就诊于中山大学肿瘤防治中心的153例胃肠道恶性肿瘤家族史阳性的结直肠癌患者,采用一般资料调查表、就诊情况调查表对其进行问卷调查。结果从发现症状到目标医院就诊时间中位数为15.00周,平均(18.15±12.43)周,>12周61例,就诊延误率高达39.9%。多元回归分析显示,体检情况(t=-4.254,P<0.001)、患癌亲属人数(t=2.405,P=0.017)和居住地(t=2.565,P=0.011)是影响患者就诊时间的主要因素,P<0.05。患者既往体检接受率低(42.5%),多数人体检未将肠癌筛查列为常规。结论家族史阳性的结直肠癌患者就诊延误现象严重,宜更深入普及结直肠癌防治知识和高危人群的肠癌筛查,尤其要关注落后、农村地区的民众;以肠癌患者为切入点,提高其亲属的肠癌筛查率,是针对性强而有效可行的方法。OBJECTIVE Active treatment of precancerous lesions and early diagnosis and treatment is the key to preventing and curing colorectal cancer,especially for people with positive family history.There were few studies on colorectal cancer screening and delay in colorectal cancer patients with positive family history in China.This study was to describe the current situation of health-seeking delay in colorectal cancer patients with gastrointestinal malignant tumor family history and identify the influencing factors of health-seeking delay.METHODS With convenient sampling methods,totally 153 participants from Sun Yat-sen University Cancer Center in Guangzhou were recruited from January 2016 to December 2016.Participants were investigated using a self-developed questionnaire.RESULTS The median of health-seeking delay time was 15.00 weeks.Its average level was（18.15±12.43）weeks.The rate of health-seeking delay was 39.9%.Multiple logistic regression showed that physical examination（t=-4.254,P〈0.001）,the number of patients with gastrointestinal malignant tumor in their family（t=2.405,P=0.017）and residence（t=2.565,P=0.011）were the major influential factors（P〈0.05）.The patients had a low rate of physical examination（42.5%）,most of which did not regard Colorectal Cancer Screening as a routine medical examination.CONCLUSIONS Health-seeking delay occurred severely among colorectal cancer patients with gastrointestinal malignant tumor family history.The prevention and screening knowledge should be popularized among colorectal cancer high-risk group,especially in rural area.Patient-centred education to improve the screening rate of patients＇ relatives is a effective method to reduce the health-seeking delay and improve outcomes in patients with colorectal cancer.

关 键 词：结直肠癌 家族史 遗传性肠癌 就诊延误 

分 类 号：R735[医药卫生—肿瘤]