扬中市上消化道癌高危人群内镜筛查效果分析  

Analysis on the effectiveness of endoscopic screening in high risk population of upper gastrointestinal cancer in Yangzhong City

作　　者：冯祥 华召来[1] 钱东福 周琴[1] 施爱武[1] 宋统球 陈茹 魏文强 王贵齐 周金意[5] FENG Xiang;HUA Zhao-lai;QIAN Dong-fu;ZHOU Qin;SHI Ai-wu;SONG Tong-qiu;CHEN Ru;WEI Wen-qiang;WANG Gui-qi;ZHOU Jin-yi(Yangzhong Cancer Research Institute,Yangzhong Peopie's Hospital,Yangzhong 212200,P.R.China;School of Medicine and Politics,Nanjing Medical University,Nanjing 211166,P.R.China;National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,P.R.China;Institute of Chronic Noncommunicable Diseases,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,P.R.China)

机构地区：[1]扬中市人民医院肿瘤防治研究所,江苏扬中212200 [2]南京医科大学医政学院,江苏南京211166 [3]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肿瘤登记办公室,北京100021 [4]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内镜室,北京100021 [5]江苏省疾病预防控制中心慢性非传染性疾病防治所,江苏南京210009

出　　处：《中华肿瘤防治杂志》2020年第18期1476-1482,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家重点研发计划(2016YFC0901400,2016YFC1302800);国家自然科学基金(81974493);中国医学科学院医学与健康科技创新工程(2019-I2M-2-004)。

摘　　要：目的食管癌和胃癌是常见的高发上消化道癌症,严重威胁着居民的生命健康安全。本研究分析高危人群内镜筛查对扬中市上消化道癌发病和死亡风险的影响。方法收集2006-10-11-2012-12-31扬中市农村上消化道癌筛查研究队列中40~69岁人群发病数据和2006-2015年肿瘤登记报告系统中上消化道癌发病和死亡的随访数据。将目标镇中整群抽取的人群作为干预组(干预组包括筛查组和未筛查组),同镇未整群抽取到的人群作为对照组。采用相对危险度(relative risk,RR)评估上消化道癌筛查干预的有效性。结果研究队列共纳入132 411人。其中,干预组46 025人(筛查组12 768人,未筛查组33 257人),对照组86 386人。干预组中位随访时间6年,对照组中位随访时间10年。与对照组相比,筛查组上消化道癌发病和死亡风险分别降低26%(RR=0.74,95%CI为0.64~0.84)和46%(RR=0.54,95%CI为0.43~0.67)。干预组上消化道癌发病风险增加4%(RR=1.04,95%CI为0.97~1.10),死亡风险降低6%(RR=0.94,95%CI为0.86~1.04),但差异均无统计学意义,均P>0.05。结论上消化道癌高危人群内镜筛查可以发现相当数量的癌前病变和上消化道癌症患者,从而能够促使患者尽早就医,进而降低扬中市居民的上消化道癌的发病率和死亡率。OBJECTIVE Esophageal cancer and stomach cancer are common high-risk upper digestive tract cancers,which seriously threaten the lives,health and safety of residents.This study aimed to analyze the effect of endoscopic screening on the incidence and mortality risk of upper gastrointestinal cancer in Yangzhong city.METHODS The incidence data of upper gastrointestinal cancer in the cohort of rural upper gastrointestinal cancer screening study in Yangzhong City from October 11,2006 to December 31,2012 and the follow-up data of incidence and death of upper gastrointestinal cancer in the tumor registration report system from 2006 to 2015 were collected.The screened population was defined as the screened group,the population sampled by cluster in the target town was defined as the intervention group,and the rest population in the same town was defined as the control group.The relative risk(RR)was used to evaluate the effectiveness of upper gastrointestinal cancer screening intervention.RESULTS The entire study cohort included 132 411 people.Among them,46 025 were in the intervention group(12 768 in the screening group and 33 257 in the unscreening group),and 86 386 in the control group.The median follow-up time for the intervention group was 6 years,and the median followup time for the control group was 10 years.Compared with the control group,the screened group had a 26%(RR=0.74,95%CI:0.64-0.84)lower risk of upper gastrointestinal cancer and a 46%(RR=0.54,95%CI:0.43-0.67)lower risk of death.Meanwhile,the risk of upper gastrointestinal cancer in the intervention group increased by 4%(RR=1.04,95%CI:0.97-1.10)and the risk of death decreased by 6%(RR=0.94,95%CI:0.86-1.04),but the differences were not statistically significant(all P>0.05).CONCLUSIONS Endoscopic screening of high-risk people with upper gastrointestinal cancer can find a considerable number of precancerous lesions and patients with upper gastrointestinal cancer,so that patients can seek medical treatment as soon as possible,thereby reducing the incidence and m

关 键 词：上消化道癌症 内窥镜筛查 扬中市 发病率 死亡率 

分 类 号：R730.1[医药卫生—肿瘤]