2018—2019年浙江省兰溪市结直肠癌筛查不同方案筛查效果的比较  

Comparison of Screening Effectiveness of Different Protocols for Colorectal Cancer Screening in Lanxi County of Zhejiang Province, 2018—2019

作　　者：蓝柳豪 徐美慧 吴胜智 王宝权 章喆 卢明 王乐 郑卫方 LAN Liu-hao;XU Mei-hui;WU Sheng-zhi;WANG Bao-quan;ZHANG Zhe;LU Ming;WANG Le;ZHENG Wei-fang(Lanxi Red Cross Hosptial,Lanxi 321100,China;Lanxi Hospital of Traditional Chinese Medicine,Lanxi 321100,China;Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Zhejiang Cancer Hospital,Institute of Basic Medicine and Cancer(IBMC),Chinese Academy of Sciences,Hangzhou 310022,China)

机构地区：[1]兰溪市红十字医院,浙江兰溪321100 [2]兰溪市中医院,浙江兰溪321100 [3]中国医学科学院北京协和医学院北京协和医院,北京100730 [4]浙江省肿瘤医院中国科学院基础医学与肿瘤研究所,浙江杭州310022

出　　处：《中国肿瘤》2023年第3期209-218,共10页China Cancer

摘　　要：[目的]比较结肠镜、免疫粪便隐血检测法(fecal immunochemical test,FIT)、新型风险分级筛查方案在浙江省兰溪市人群中的筛查效果。[方法]收集2018年6月—2019年6月浙江省兰溪市50~74岁满足研究条件的居民基线资料,并将其按照1∶2∶2比例随机分配至结肠镜组、FIT组、新型风险分级筛查组。结肠镜组进行结肠镜检查;FIT组首先进行FIT检测,FIT阳性者接受结肠镜检查;新型风险分级筛查组根据风险评估结果开展筛查,其中被评估为高危者接受结肠镜筛查,而被评估为低危者接受FIT筛查。比较3组间的人群参与率、结直肠肿瘤检出率及每检出1例进展期肿瘤所需结肠镜数。[结果]兰溪市基线共招募2 700名受试者入组,纳入男性1 154名(43.4%),50~59岁者1 225名(46.1%)。相比结肠镜组(60.0%),FIT组(99.2%)和新型风险分级筛查组(92.0%)的人群参与率更高。相比结肠镜组(7.5%),FIT组(3.4%)和新型风险分级筛查组(3.8%)的进展期肿瘤(结直肠癌+进展期腺瘤)检出率较低。结肠镜组、FIT组、新型风险分级筛查组每检出1例进展期肿瘤所需结肠镜数分别为13、4、6。[结论]相比结肠镜方案,基于新型风险分级筛查或FIT的结直肠癌筛查方案可提高人群筛查参与率,且可节约结肠镜资源。[Purpose] To compare the effectiveness of colorectal cancer(CRC) screening undergoing colonoscopy,fecal immunochemical test(FIT),and the risk grading screening method among population in Lanxi County of Zhejiang Province.[Methods] During June 2018 to June 2019,qualified subjects aged 50~74 years old in Lanxi County were recruited and randomly assigned into colonoscopy group,FIT group and new risk grading screening group in a ratio of 1:2:2.In the colonoscopy group,subjects underwent colonoscopy examination directly;in the FIT group,subjects received FIT,and those with positive FIT were referred for colonoscopy;in the new risk grading screening group,subjects were assessed by risk grading,then high-risk subjects were referred for colonoscopy,while the low-risk ones were referred for FIT.The population participation rates,the detection rates of colorectal neoplasm,and the number of colonoscopies needed to screen were calculated and compared among the three groups.[Results] A total of 2 700 subjects were recruited,including 1 154 males(43.4%) and 1 225 subjects(46.1%) aged 50~59 years old.The FIT group(99.2%) and the new risk grading screening group(92.0%) had higher participation rates than the colonoscopy group(60.0%),respectively.Compared with the colonoscopy group(7.5%),the FIT group(3.4%) and the new risk grading screening group(3.8%) had a lower detection rate of advanced neoplasm(colorectal cancer or advanced adenoma),respectively.The number of colonoscopies needed to screen in the colonoscopy group,FIT group and new risk grading screening group were 13,4 and 6,respectively.[Conclusion] CRC screening using both FIT method and the risk grading screening method could improve the population participation rates and save colonoscopy resources when compared with using colonoscopy.

关 键 词：结直肠癌 筛查 结肠镜 免疫粪隐血检测法 风险分级筛查方案 浙江 

分 类 号：R73-31[医药卫生—肿瘤] R735[医药卫生—临床医学]