网络筛查结合居家大便潜血试验对结直肠癌筛查效果的初步评估  

A preliminary evaluation of internet screening combined with home-administered fecal occult blood test for colorectal cancer screening effect

作　　者：唐刚 魏正强[1] 曾凡玲[2] 罗跃[2] 柴宁辉 赵冬琴[1] 彭旭东[1] TANG Gang;WEI Zhengqiang;ZENG Fanling;LUO Yue;CHAI Ninghui;ZHAO Dongqin;PENG Xudong(Department of Gastrointestinal Surgery;Health Management Center,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院胃肠外科,400016 [2]重庆医科大学附属第一医院健康管理中心,400016

出　　处：《重庆医学》2022年第21期3659-3664,共6页Chongqing medicine

基　　金：重庆市科卫联合医学科研项目(2018ZDXM007);重庆市重点疾病防治技术攻关课题(2019ZX003)。

摘　　要：目的构建结直肠癌早诊早治互联网平台,结合居家大便潜血试验(FOBT),建立信息时代下的居家网络筛查模式,初步探究此模式在我国的可行性和有效性。方法采用横断面调查研究,选取2020年6-11月于该院进行健康体检的人群为筛查对象。利用已构建的微信小程序“早筛助手”辅助居民完成结直肠癌风险评估问卷和居家FOBT,并进行结果回收。通过“早筛助手”进行初筛结果反馈,并建议高风险者完善结直肠镜。对居家FOBT完成率、FOBT合格率、FOBT阳性率、初筛高风险评估率、肠镜依从性、肠镜病变检出率进行评估。结果“早筛助手”共收集到有效问卷1362份,发出FOBT试剂1033份,完成FOBT 563人,合格524人,初筛高风险262人,进行肠镜检查88例,阳性检出38例,其中进展期腺瘤和肠癌共6例。居家FOBT完成率和合格率分别为54.50%、93.07%。初筛高风险率50.00%,而肠镜依从性和检出率则达到了33.59%,43.18%。结论借助互联网和居家FOBT的筛查模式是一种行之有效的肠癌筛查方式。Objective To construct an internet platform for early diagnosis and early treatment of colorectal cancer,to establish a home-administered network screening model under the information era by combining with home-administered fecal occult blood test(FOBT),and to preliminarily explore the feasibility and effectiveness of this model in our country.Methods A cross-sectional study was conducted.The people undergoing the healthy physical examination in this hospital from June to November 2020 were selected as the screening subjects.The established WeChat mini program“Early Screening Assistant”was used to assist the residents to complete the colorectal cancer risk assessment questionnaire and home-administered FOBT,and the results were recovered.The feedback of initial screening results through“Early Screening Assistant”was performed,and the people with high risk were recommended to complete the colonoscopic examination.The FOBT completion rate,FOBT qualified rate,FOBT positive rate,high risk assessment rate of initial screening,colonoscopy compliance,and colonoscopy lesion detection rate were evaluated.Results A total of 1362 valid questionnaires were collected by“Early Screening Assistant”,1033 FOBT reagents were sent out,and 563 cases completed FOBT,of which 524 cases were qualified,and 262 cases were at high risk by preliminary screening.The colonoscopic examination was conducted in 88 cases,38 positive cases were detected out,including 6 cases of advanced adenoma and colorectal cancer.The completion rate and pass rate of home-administered FOBT were 54.50%and 93.07%,respectively.The high risk rate of primary screening was 50.00%,and the colonoscopy compliance and detection rates were 33.59%and 43.18%,respectively.Conclusion The internet and home-administered FOBT screening is an effective way to screen colorectal cancer,which is worthy of further promotion and exploration.

关 键 词：结直肠癌 网络筛查 居家大便潜血试验 结肠镜检查 直肠镜检查 依从性 

分 类 号：R735.3[医药卫生—肿瘤]