上海市嘉定区居民结直肠癌2次筛查的依从性分析  

Compliance of residents with repeated screening for colorectal cancer in Jiading District,Shanghai

作　　者：陈单 王亚伟 黄芳[2] 徐一凡 向芳[2] 张一英[2] 王娜[1] 邵月琴[2] CHEN Dan;WANG Yawei;HUANG Fang;XU Yifan;XIANG Fang;ZHANG Yiying;WANG Na;SHAO Yueqin(School of Public Health,Fudan University,Shanghai 200032,China;Jiading District Center for Disease Control and Prevention,Shanghai 201800,China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]上海市嘉定区疾病预防控制中心,上海201800

出　　处：《上海预防医学》2024年第7期706-711,共6页Shanghai Journal of Preventive Medicine

基　　金：上海市嘉定区公共卫生高质量发展重点学科项目(GWGZLXK-2023-02)。

摘　　要：【目的】探索上海市嘉定区居民结直肠癌2次筛查依从性及相关因素,为嘉定区结直肠癌防控提供科学依据。【方法】依托嘉定区自然人群队列,根据研究对象2017—2019、2020—2022年筛查情况分为从不参加筛查和参加筛查,其中参加筛查又分为参加1轮筛查和重复筛查。应用SPSS 21.0软件分析各组的人口学特征,采用χ^(2)检验或Fisher精确概率法对性别、年龄、文化程度、婚姻状况、退休状况、医疗保险类型等因素进行单因素分析。选取P<0.05的因素纳入多因素分析,采用多因素logistic回归分析重复筛查依从性的相关因素。【结果】纳入研究对象8179人。其中男性3323人、占40.6%,女性4856人、占59.4%;平均年龄(61.26±6.06)岁;文化程度小学及以下者2652人(32.4%),中学4242人(51.9%),中学以上1285人(15.7%);大多数人为在婚状态,有7579人(92.7%)。4062人从未参加过筛查,4117人参加过筛查,其中1485人重复筛查、重复筛查率18.2%。多因素logistic回归分析结果显示相较于男性,女性重复筛查依从性较好(OR=1.31,95%CI:1.14~1.50);与50~54岁的人群相比,年龄55~59岁(OR=1.57,95%CI:1.19~2.08)、60~64岁(OR=2.77,95%CI:2.13~3.61)、65~69岁(OR=3.31,95%CI:2.51~4.36)人群重复筛查依从性更高;与职工医疗保险的居民相比,居民医疗保险人群的重复筛查依从性更差(OR=0.76,95%CI:0.66~0.87);与无肠息肉史的人群相比,有肠息肉史的人群更有可能进行重复筛查(OR=2.07,95%CI:1.50~2.87)。【结论】结直肠癌重复筛查依从性仍有待提高,不同特征人群的重复筛查依从性存在差异,识别社区结直肠癌筛查依从性不高的群体,有针对性地采取干预措施,有助于提高居民对结直肠癌筛查的持续依从性。[Objective]To explore the compliance related factors of repeated screening for colorectal cancer in Jiading District,and to provide a scientific basis for the prevention and control of colorectal cancer.[Methods]Based on the natural population cohort in Jiading District,and the screening situation in 2017‒2019 and 2020‒2022,the study subjects were divided into the groups of never participating in screening and participating in screening.Subjects in the participating group were further divided into participating in one round of screening or having repeated screening.SPSS 21.0 software was used to analyze the demographic characteristics of each group.χ^(2) test or Fisher precise probability test were used to conduct univariate analysis of the factors such as gender,age,education level,marital status,retirement status,and type of medical insurance.Factors with the significant difference(P<0.05)were selected for inclusion in multivariate analysis,and factors related to compliance with repeated screening were analyzed by multivariate logistic regression.[Results]A total of 8179 subjects were included in the study,including 3323 males(40.6%)and 4856 females(59.4%).The average age of the subjects was(61.26±6.06)years old.A total of 2652(32.4%)had educated in primary school or below,4242(51.9%)in secondary school,and 1285(15.7%)in higher secondary school.Mostly,7579(92.7%)were married.Among the participants,4062 people had never participated in screening,4117 people had participated in screening,and 1485 of them had repeated screening,with a repeated screening rate of 18.2%.Multivariate logistic regression analysis showed that women had better compliance with repeated screening than men(OR=1.31,95%CI:1.14‒1.50).Compared with the population aged 50 to 54 years,the population aged 55‒59 years(OR=1.57,95%CI:1.19‒2.08),60-64 years(OR=2.77,95%CI:2.13‒3.61),and 65-69 years(OR=3.31,95%CI:2.51‒4.36)had higher compliance with repeated screening.Compared with employees'medical insurance,residents'medical insurance

关 键 词：结直肠癌 两次筛查 相关因素 LOGISTIC回归分析 

分 类 号：R730.1[医药卫生—肿瘤]