2018—2020年南昌市城市女性乳腺癌高危人群筛查结果  

Analysis of screening results of urban female population at high risk of breast cancer in Nanchang,2018-2020

作　　者：熊小玲[1] 徐艳[2] 任剑[1] 王晓波 舒虹 熊婉菁 刘斌 魏清风[1] XIONG Xiaoling;XU Yan;REN Jian;WANG Xiaobo;SHU Hong;XIONG Wanjing;LIU Bin;WEI Qingfeng(Cancer Center Office,Jiangxi Cancer Hospital,Nanchang,Jiangri 330029,China)

机构地区：[1]江西省肿瘤医院癌症中心办公室,江西南昌330029 [2]江西省疾病预防控制中心慢性非传染性疾病防制所

出　　处：《中国预防医学杂志》2023年第8期801-805,共5页Chinese Preventive Medicine

基　　金：财政部国家卫生计生委2018年公共卫生服务补助资金项目(财社[2017]198号);江西省卫生健康委科技计划项目(SKJP220218464)。

摘　　要：目的分析南昌市城市女性乳腺癌高危人群筛查结果,为探索适宜城市地区乳腺癌筛查管理模式提供依据。方法2018年9月—2021年5月,在江西省南昌市选择8个区作为项目点,采用整群抽样的方法,对40~74岁常住户籍女性开展癌症风险问卷调查和评估,对评估出的乳腺癌高危人群按城市癌症早诊早治项目技术方案开展临床筛查,计算乳腺癌高危率、筛查依从性、阳性检出率等结果,并采用Poisson回归模型分析乳腺癌阳性病变检出的相关因素。结果31952人完成问卷调查及乳腺癌风险评估,乳腺癌高危人群8689人(27.19%);完成乳腺癌临床筛查4143人,筛查依从性47.68%,可疑阳性率26.43%(1095/4143),阳性率2.12%(88/4143);单纯乳腺B超筛查检出可疑阳性率20.81%(862/4143),阳性率0.89%(37/4143);单纯乳腺X线摄影筛查检出可疑阳性率11.55%(453/3923),阳性率1.53%(60/3923);乳腺B超和乳腺X线摄影并联筛查检出可疑阳性率26.84%(1053/3922),阳性率2.17%(85/3922)。多因素Poisson回归模型分析显示,与无乳腺良性病史者、无乳腺癌家族史者相比,有乳腺良性病史(IRR=3.19,95%CI:1.95~5.21)、有乳腺癌家族史(IRR=1.67,95%CI:1.08~2.57)人群乳腺癌阳性率更高。结论对乳腺癌高危人群进行乳腺B超并联乳腺X线筛查有助于发现乳腺癌阳性病变,但筛查依从性还有待进一步提高。Objective To analyze the screening results of urban women at high risk of breast cancer in Nanchang City,Jiangxi Province from 2018 to 2020,so as to provide evidence for exploring appropriate management model of breast cancer screening in urban areas.Methods Eight districts in Nanchang City,Jiangxi Province,were selected as project sites,where permanent female residents aged 40-74 years were selected using cluster sampling method for questionnaire survey and evaluation of cancer risk.Clinical screening was carried out,following the technical plan of Urban Cancer Early Diagnosis and Early Treatment Project in China,for women evaluated as at high risk of breast cancer.The highrisk rate of breast cancer,screening compliance and detection rate of positive lesions were estimated.Poisson regression model was used to analyze the factors related to the detection of positive breast cancer lesions.Results A total of 31952 women completed questionnaires and breast cancer risk assessment,among whom 8689(27.19%)were identified as at high risk of breast cancer.Among those high-risk individuals,4143 received clinical screening,resulting in a screening compliance of 47.68%.The rate of suspicious positive lesion was 26.43%(1095/4143),and the positive rate was 2.12%(88/4143).The rate of suspicious positive lesion and the positive rate for breast ultrasound screening were 20.81%(862/4143)and 0.89%(37/4143),respectively;those for mammography screening were 11.55%(453/3923)and 1.53%(60/3923),respectively;and those for breast ultrasound combined with mammography were 26.84%(1053/3922)and 2.17%(85/3922),respectively.The results of multivariable Poisson regression analysis showed that compared with people without benign breast disease history and family history of breast cancer,people who had benign breast disease history and those with family history of breast cancer had higher detection rate of positive lesions(incidence rate ration(IRR)=3.19,95%CI:1.95-5.21;IRR=1.67,95%CI:1.08-2.57).Conclusions Breast ultrasound combined with mammogr

关 键 词：乳腺癌 城市 女性 癌症 筛查 

分 类 号：R737.9[医药卫生—肿瘤]