居民对结直肠癌新型粪便免疫化学检测筛查技术接受及评价情况的多中心调查  

Population's acceptance and attitude toward a novel fecal immunochemical test for colorectal cancer screening:a multi‑center survey in China

作　　者：王红 刘成成 白方舟 朱娟 严鑫鑫 曹梦迪 杜灵彬 魏东华[3] 王德斌[4] 廖先珍[5] 董栋[6] 高屹 董佩[8] 朱陈 马艳玲 柴静[4] 肖海帆 孔蕴馨 张强 郑卫方 应荣彪 周海 任建松 李霓 陈宏达 石菊芳 代敏 Wang Hong;Liu Chengcheng;Bai Fangzhou;Zhu Juan;Yan Xinxin;Cao Mengdi;Du Lingbin;Wei Donghua;Wang Debin;Liao Xianzhen;Dong Dong;Gao Yi;Dong Pei;Zhu Chen;Ma Yanling;Chai Jing;Xiao Haifan;Kong Yunxin;Zhang Qiang;Zheng Weifang;Ying Rongbiao;Zhou Hai;Ren Jiansong;Li Ni;Chen Hongda;Shi Jufang;Dai Min(Office of Cancer Screening,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Institute of Cancer and Basic Medicine,Chinese Academy of Sciences/Department of Cancer Prevention,Cancer Hospital of the University of Chinese Academy of Sciences/Department of Cancer Prevention,Zhejiang Cancer Hospital,Hangzhou 310022,China;Office for Cancer Prevention and Control,Anhui Provincial Cancer Hospital,Hefei 230032,China;School of Health Services Management,Anhui Medical University,Hefei 230032,China;The Department of Cancer Prevention and Control,Hunan Provincial Cancer Hospital,Changsha 410006,China;Office of Cancer Prevention and Treatment,Xuzhou Cancer Hospital,Xuzhou 221000,Jiangsu Province,China;Department of Colorectal Surgery,Department of Tumor Hospital of Yunnan Province/Third Affiliated Hospital of Kunming Medical University,Kunming 650118,China;Department of Public Health Strategy Research,Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China;Department of Cancer Prevention,Department of Tumor Hospital of Yunnan Province/Third Affiliated Hospital of Kunming Medical University,Kunming 650118,China;Department of Proctology,Lanxi Red Cross Hospital,Lanxi 321100,Zhejiang Province,China;Department of Surgical Oncology,Taizhou Cancer Hospital,Taizhou 317502,Zhejiang Province,China;Administrative Management Office,Yunnan Cancer Hospital/The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Center,Kunming 650118,China)

机构地区：[1]国家癌症中心国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室,北京100021 [2]中国科学院大学肿瘤与基础研究所,中国科学院大学附属肿瘤医院防治科浙江省肿瘤医院防治科,杭州310022 [3]安徽省肿瘤医院防癌科,合肥230032 [4]安徽医科大学卫生管理学院,合肥230032 [5]湖南省肿瘤医院肿瘤防治办公室,长沙410006 [6]江苏省徐州市肿瘤医院肿瘤防治办公室,221000 [7]云南省肿瘤医院昆明医科大学第三附属医院结直肠外科,650118 [8]中国医学科学院医学信息研究所公共卫生战略情报研究室,北京100020 [9]云南省肿瘤医院昆明医科大学第三附属医院健康管理与肿瘤筛查中心,昆明650118 [10]浙江省兰溪市红十字医院肛肠科,321100 [11]浙江省台州市肿瘤医院肿瘤外科,317502 [12]云南省肿瘤医院昆明医科大学第三附属医院云南省癌症中心癌症中心办公室,650118

出　　处：《中华预防医学杂志》2020年第7期760-767,共8页Chinese Journal of Preventive Medicine

基　　金：中国医学科学院医学与健康科技创新工程项目(2017‑I2M‑1‑006);美国中华医学基金会卫生政策与体系科学公开竞标项目(19‑340);国家自然科学基金(81773521);中国医学科学院中央级公益性科研院所基本科研业务费青年医学人才奖励项目(2018RC330001)。

摘　　要：目的了解居民对新型粪便免疫化学检测(FIT)技术的整体主观接受情况及对筛查流程不同环节的评价情况。方法于2018年5月至2019年5月,以5个省份(浙江、安徽、江苏、湖南和云南)为研究现场,招募2474名50~74岁人群为研究对象。通过问卷调查获得一般人口学特征、对FIT接受和评价情况及FIT筛查各环节遇到困难。采用多因素logistic回归模型分析取样、结果读取和结果上传过程所遇困难的相关因素。结果研究对象的年龄为(60.0±6.4)岁,女性、受教育程度为高中/中专及以上、无业人员/退休/其他、已婚、新型农村合作医疗者分别占61.7%(1526名)、29.0%(718名)、34.3%(849名)、92.7%(2293名)、31.3%(775名)。居民对FIT技术总体主观接受度为94.8%;取样、结果读取和上传环节遇到困难者分别占33.1%(819名)、46.4%(1147名)和62.9%(1557名);主要困难在不确定取样操作是否标准(28.0%)、无法准确判断结果显示(32.5%)以及不使用智能手机而需帮忙(44.2%)。多因素logistic回归模型分析结果显示,65~74岁、医保状况为新型农村合作医疗者在取样过程遇到困难的可能性较高,无业人员/退休/其他和共同生活家庭成员数大于在3人及以上者在取样过程遇到困难的可能性较低;65~74岁、农民或农民工、医保状况为新型农村合作医疗者在结果读取中遇到困难的可能性较高,共同生活家庭成员数在3人及以上者在结果读取中遇到困难的可能性较低;医保状况为新型农村合作医疗者在结果上传过程遇到困难的可能性较高,教育水平为高中/中专及以上、共同生活家庭成员数为3人及以上者在结果上传过程遇到困难的可能性较低。结论居民对新型FIT技术主观接受度较高;年龄、教育水平、职业、共同生活家庭成员数和医保状况可能与取样、结果读取和结果上传过程所遇困难有关联。Objective To investigate the acceptance and attitude toward a novel fecal immunochemical test(FIT)in colorectal cancer screening among populations in China.Methods From May 2018 to May 2019,2474 people aged 50-74 years were recruited from five provinces of China(Zhejiang,Anhui,Jiangsu,Hunan and Yunnan).The general demographic characteristics,acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey.Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool,reading and uploading results.Results The subjects were(60.0±6.4)years old,and female,high school of above educated,unemployed/retired/other,married and with medical insurance status of"new rural cooperative medical care(NRCMC)"accounted for 61.7%(1526),29.0%(718),34.3%(849),92.7%(2293)and 31.3%(775),respectively.The population's acceptance of the FIT technology was 94.8%.In the process of FIT screening,the percentage of occurred difficulties in sampling stool,reading and uploading results were 33.1%(819),46.4%(1147)and 62.9%(1557),respectively.The main difficulties were the uncertainty about whether the sampling operation was standard(28.0%),the inability to accurately judge the result displayed(32.5%)and the need for help without using a smartphone(44.2%).The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of"NRCMC"were more likely to encounter difficulties in sampling,and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling.Those aged 65-74 years old,farmers or migrant workers,and those with"NRCMC"were more likely to encounter difficulties in readingresults,and those with 3 or more family members were less likely to encounter difficulties in reading result.Those with"NRCMC"were more likely to encounter difficulties in uploading results,and th

关 键 词：结直肠肿瘤 评价研究 免疫化学 筛查 

分 类 号：R735.34[医药卫生—肿瘤]