辽宁省2012-2019年农村居民结直肠癌患病影响因素分析  

Analysis of influencing factors of colorectal cancer in rural residents from 2012 to 2019 in Liaoning Province

作　　者：佟爽[1] 阎佳宁 尚德高[1] 秦怡[1] 王维琴 范建瑞 孙笠翔[4] 于连政[1] TONG Shuang;YAN Jia-ning;SHANG De-gao;QIN Yi;WANG Wei-qin;FAN Jian-rui;SUN Li-xiang;YU Lian-zheng(Liaoning Center for Disease Control and Prevention,Shenyang 110005,China;Cancer Screening Office,First Hospital of Sujiatun District,Shenyang 110101,China;Office of Early Diagnosis and Treatment of Colorectal Cancer,Central Hospital of Gaizhou,Gaizhou 115200,China)

机构地区：[1]辽宁省疾病预防控制中心慢性非传染性疾病预防控制所,辽宁沈阳110005 [2]沈阳市苏家屯区第一医院肿瘤筛查办公室,辽宁沈阳110101 [3]盖州市中心医院结直肠癌早诊早治项目办公室,辽宁盖州115200 [4]辽宁省疾病预防控制中心艾滋病与性传播疾病预防控制所,辽宁沈阳110005

出　　处：《中华肿瘤防治杂志》2021年第21期1606-1610,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家重点研发计划(2018YFC1311600);辽宁省自然科学基金指导计划(2018011324-301)。

摘　　要：目的评估辽宁省农村居民结直肠癌患病影响因素,探索结直肠癌筛查管理策略。方法选取2012-07-01-2019-06-30在沈阳苏家屯区和营口盖州市居住的40~74岁常住居民,采用整群抽样的方法,按照国家推荐的结直肠癌早诊早治筛查方案通过问卷调查和便潜血检查两种方法初筛出高危人群,对高危人群行结直肠镜检查复筛,采用χ^(2)检验和多因素Logistic逐步回归分析结直肠癌患病的影响因素。结果共完成初筛164 415例,复筛17 950例,检出结直肠癌患者109例,高危人群结直肠癌检出率为0.61%(109/17 950),总体人群结直肠癌检出率为66.30/10万。单因素分析结果显示,年龄(χ^(2)=95.386,P<0.001)、便潜血(χ^(2)=10.129,P=0.002)、慢性腹泻(χ^(2)=8.390,P=0.004)、黏液血便(χ^(2)=40.664,P<0.001)、息肉个数(χ^(2)=82.192,P<0.001)与结直肠癌患病有统计学意义的关联。多因素分析结果显示,老年人(OR=4.483,95%CI为2.916~6.893,P<0.001),便潜血阳性(OR=2.575,95%CI为1.686~3.933,P<0.001),存在1种(OR=1.907,95%CI为1.014~3.588,P=0.045)、2种(OR=4.181,95%CI为2.329~7.505,P<0.001)或3种消化道症状(OR=7.509,95%CI为2.416~23.336,P=0.001),单发息肉(OR=4.630,95%CI为2.989~7.171,P<0.001)和≥3个息肉(OR=2.971,95%CI为1.513~5.833,P=0.002)是结直肠癌患病的危险因素。结论结直肠癌筛查有助于提早发现癌症患者,老年人、便潜血阳性、有1~3种消化道症状(腹泻/便秘/黏液血便)、肠镜检查有息肉是结直肠癌发病的危险因素,提示对结直肠癌的预防应该有针对性的采用综合干预措施。Objective To evaluate the influencing factors of colorectal cancer in rural residents of Liaoning Province and explore the management strategies of colorectal cancer screening.Methods The 40-74-year-old permanent residents living in Sujiatun District and Yingkou Gaizhou City,Shenyang,from July 1,2012 to June 30,2019 were selected by cluster sampling,and the high-risk population was initially screened by questionnaire survey and fecal occult blood test according to the national standard screening scheme for early diagnosis and treatment of colorectal cancer.The high-risk population was re-screened by colorectoscopy,using chi-square test and multivariate logistic analysis.The stepwise regression method was used to analyze the factors affecting the prevalence of colorectal cancer.Results A total of 164 415 cases of primary screening and 17 950 cases of re-screening were completed,109 cases of colorectal cancer were detected,the detectionrate of colorectal cancer in high-risk population was 0.61%(109/17 950),and the detection rate of colorectal cancer in the overall population was 66.30/100 000.Age(χ^(2)=95.386,P<0.001),fecal occult blood(χ^(2)=10.129,P=0.002),chronic diarrhea(χ^(2)=8.390,P=0.004),mucous and bloody stools(χ^(2)=40.664,P<0.001),number of polyps(χ^(2)=82.192,P<0.001)were statistically significant associated with the prevalence of colorectal cancer.The results of multivariate analysis showed that the elderly(OR=4.483,95%CI:2.916-6.893,P<0.001),fecal occult blood positive(OR=2.575,95%CI:1.686-3.933,P<0.001),had those with one gastrointestinal symptom(OR=1.907,95%CI:1.014-3.588,P=0.045),those with two gastrointestinal symptoms(OR=4.181,95%CI:2.329-7.505,P<0.001),or those with three gastrointestinal symptoms(OR=7.509,95%CI:2.416-23.336,P=0.001),single polyp(OR=4.630,95%CI:2.989-7.171,P<0.001)and three or more polyps(OR=2.971,95%CI:1.513-5.833,P=0.002)were risk factors for colorectal cancer.Conclusions Colorectal cancer screening is helpful for early detection of cancer patients and thus plays a role i

关 键 词：结直肠癌 肠镜 便潜血 息肉 消化道症状 

分 类 号：R735.3[医药卫生—肿瘤]