中国结直肠癌健康风险评估模型研究  

Studying the health risk assessment model of Chinese colorectal cancer

作　　者：丁兰君 赵丽中[2] 王媛 张伟华[2] 芦文丽 DING Lan-jun;ZHAO Li-zhong;WANG Yuan;ZHANG Wei-hua;LU Wen-li(School of Public Health, Tianjin Medical University, Tianjin 300070, Chin)

机构地区：[1]天津医科大学公共卫生学院流行病与卫生统计学系,天津300070 [2]天津市人民医院大肠癌筛查项目办公室

出　　处：《中国慢性病预防与控制》2018年第5期325-328,共4页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的构建适用于中国人群的结直肠癌健康风险的评估模型,为结直肠癌高危人群筛查提供理论依据。方法通过收集结直肠癌发病相关风险因素的比值比、不同水平风险因素的人群暴露率和中国结直肠癌年龄别、性别发病率等参数,建立个体在未来5年内的结直肠癌风险分数转换表,计算组合风险分数,采用SAS 9.2软件建立个体风险评价模型,预测个体发病风险。结果本研究纳入了13个危险因素,大便潜血和黏液便史的风险分数最高,均在10分左右,其次为肠息肉史(6.86分)、慢性结直肠炎病史(4.14分)、慢性腹泻(3.82分)、一级亲属肠癌史(2.42分)、慢性阑尾炎或阑尾炎手术史(2.09分)、胆囊疾病或胆囊手术史(2.01分)、慢性便秘(2.01分)和消化道溃疡史(1.91分),而吸烟(1.09分)和饮酒(1.11分)的风险分数接近1。风险分数<1的因素为吃蔬菜≥1次/d(0.78分),提示该因素为保护性因素。发病风险因素个数相同、种类不同的个体发病风险不同。相同发病风险组合分数者,年龄越高,发病风险越大;年龄相同时,男性发病风险高于女性。结论本研究建立的中国人群结直肠癌健康风险的个体化评估模型可为结直肠癌高危人群筛查提供理论依据。Objective To establish a health risk assessment model of Chinese colorectal cancer（CRC）, and to provide the basis for screening the residents with CRC high-risk. Methods The odd ratio values related to CRC prevalence, the exposure rate of residents with different levels of risk factors, and the age, gender, morbidity of CRC were collected. The individual 5-year risk score was developed using a health risk assessment model, the combined risk score was calculated. SAS 9.2 software was used to develop the individual risk assessment model for predicting the individual risk. Results There were 13 risk factors in present study. The risk scores（10.13 and 9.51） of fecal occult blood and history of mucous stool were the highest; the risk scores of rectal polyp, chronic colitis, chronic diarrhea, family history of CRC, chronic appendicitis or appendix operation, gallbladder diseases or cholecystectomy, chronic constipation, peptic ulcer, smoking and drinking were 6.86, 4.14, 3.82, 2.42, 2.09, 2.01, 2.01, 1.91, 1.09 and 1.11, respectively. The risk score of eating vegetables only was 0.78, which was a protective factor. The individual risk in residents with the same number of risk factors but the different risk types was different. In the residents with the same combined risk scores, the risk score increased with age; in the residents with the same age, the risk score of males was higher than that of females. Conclusion A health risk assessment model of Chinese colorectal cancer could provide the theory basis for screening the residents with CRC high-risk.

关 键 词：结直肠癌 风险因素 风险评估 风险分数 

分 类 号：R735.3[医药卫生—肿瘤]