2015—2019年广州市结直肠癌筛查不同初筛方式阳性人群肠镜结果分析  

Comparison of Colonoscopy Results in Participants with High Risk Assessed by Different Criteria in Colorectal Cancer Screening Program in Guangzhou,2015—2019

作　　者：李科[1] 刘华章[1] 林国桢[1] 李燕[1] 梁颖茹[1] 秦鹏哲[1] LI Ke;LIU Hua-zhang;LIN Guo-zhen;LI Yan;LIANG Ying-ru;QIN Peng-zhe(Guanghzhou Center for Disease Control and Prevention,Guangzhou 510440,China)

机构地区：[1]广州市疾病预防控制中心,广东广州510440

出　　处：《中国肿瘤》2021年第3期199-205,共7页China Cancer

基　　金：广东省医学科学技术项目基金项目(B2019177)。

摘　　要：[目的]分析2015—2019年广东省广州市结直肠癌筛查的数据,比较不同初筛方式阳性人群肠镜结果,以期更好地动员居民参与肠镜检查。[方法]整理2015—2019年广州市结直肠癌筛查数据,将初筛阳性人群分为5组:仅高危因素问卷评估阳性(免疫化学法粪便隐血试验阴性)[high risk factor questionnaire (HRFQ) positive and fecal immunochemical test(FIT)negative,HRFQ+&Double-FIT-]、HRFQ阳性和1次FIT阳性(HRFQ+&Single-FIT+)、HRFQ阴性和1次FIT阳性(HRFQ-&Single-FIT+)、HRFQ阴性和2次FIT阳性(HRFQ-&DoubleFIT+)、HRFQ阳性和2次FIT阳性(HRFQ+&Double-FIT+)。采用多元Logistic回归比较不同初筛方式阳性人群肠镜结果。[结果]广州市共完成初筛403 585人,初筛阳性69 619人,初筛阳性率为17.25%,肠镜检查依从性为28.53%;HRFQ+&Double-FIT+、HRFQ-&DoubleFIT+、HRFQ-&Single-FIT+、HRFQ+&Single-FIT+组检出异常风险分别是HRFQ+&DoubleFIT-组的1.638、1.642、1.174和1.515倍,HRFQ-&Double-FIT+和HRFQ+&Single-FIT+组检出腺瘤风险分别是HRFQ+&Double-FIT-组的1.306和1.214倍,HRFQ+&Double-FIT+、HRFQ-&Double-FIT+、HRFQ-&Single-FIT+、HRFQ+&Single-FIT+检出进展性腺瘤风险分别是HRFQ+&Double-FIT-组的4.823、5.870、2.571和2.463倍,HRFQ+&Double-FIT+、HRFQ-&Double-FIT+、HRFQ-&Single-FIT+、HRFQ+&Single-FIT+检出肠癌风险分别是HRFQ+&Double-FIT-组的33.532、31.345、5.353和6.627倍。[结论]广州市结直肠癌筛查肠镜检查依从性较低,应加大对结直肠癌初筛阳性人群的动员,尤其是FIT 2次阳性的人群。[Purpose] To compare colonoscopy results in participants with high risk assessed by different criteria in colorectal cancer screening program in Guangzhou,2015—2019. [Methods]Data of colorectal cancer screening in Guangzhou from 2015 to 2019 were collected. The high risk participants were divided into 5 groups according the primary risk assessment results:high risk questionnaire(HRFQ) positive plus two fecal immunochemical tests(FIT)negative(HRFQ+ & Double-FIT-),HRFQ positive and single FIT positive(HRFQ + & Single-FIT +),HRFQ negative and single FIT positive(HRFQ-& Single-FIT+),HRFQ negative and double FIT positive(HRFQ-&Double-FIT+),HRFQ positive and double FIT positive(HRFQ+ & double-FIT+). All high risk participants were subjected for colonoscopic examination,and the multiple Logistic regression was used to compare colonoscopy results in different groups. [Results] Among total 403 585 participants,there were 69 619 identified as high risk subjects(17.25%) and the overall compliance rate of colonoscopy was 28.53%(19862/69619). The high risk rates in groups HRFQ+ & Double-FIT+,HRFQ-& Double-FIT+,HRFQ-& Single-FIT+,HRFQ+ & Single-FIT+ were 1.638,1.642,1.174 and 1.515 times higher as group HRFQ+ & Double-FIT-,respectively.The detective rates of adenoma in groups HRFQ-& Double-FIT + and HRFQ + & Single-FIT + were 1.306 and 1.214 times higher as HRFQ + & Double-FIT-,respectively. The detective rates of advanced adenomas in groups HRFQ+ & Double-FIT+,HRFQ-& Double-FIT+,HRFQ-& Single-FIT+,HRFQ+ & Single-FIT + were 4.823,5.870,2.571 and 2.463 times higher asgroup HRFQ + & Double-FIT-,respectively. The detective rates of colorectal cancerin groups HRFQ + & Double-FIT +,HRFQ-& Double-FIT +,HRFQ-& Single-FIT +,HRFQ + & Single-FIT + were 33.532,31.345,5.353 and6.627 times higher as group HRFQ + & Double-FIT-,respectively. [Conclusion] The compliance rate of colonoscopy examinations for screening colorectal cancer is relatively low in Guangzhou. It is necessary to increase the compliance rate among high risk subjects,esp

关 键 词：结直肠癌 高危因素问卷评估 粪便隐血试验 初筛 肠镜 广东 

分 类 号：R735.3[医药卫生—肿瘤]