消化道肿瘤联合筛查项目胃肠镜依从性影响因素分析  

Influencing Factors for Compliance of Gastroscopy and Colonoscopy in Gastrointestinal Cancer Screening Program

作　　者：余炜燕 李雪 朱娟 王晓亮 李寿俊 杜灵彬 程向东[1,2] YU Weiyan;LI Xue;ZHU Juan;WANG Xiaoliang;LI Shoujun;DU Lingbin;CHENG Xiangdong(School of Public Health,Nanjing Medical University,Nanjing 211166,China;Zhejiang Cancer Hospital,Hangzhou Institute of Medicine(HIM),Chinese Academy of Sciences,Hangzhou 310022,China;The People's Hospital of Fenghua,Ningbo 315500,China;Health Commission of Fenghua,Ningbo 315500,China)

机构地区：[1]南京医科大学公共卫生学院,江苏南京211166 [2]浙江省肿瘤医院,中国科学院杭州医学研究所,浙江杭州310022 [3]宁波市奉化区人民医院,浙江宁波315500 [4]宁波市奉化区卫生健康局,浙江宁波315500

出　　处：《中国肿瘤》2024年第11期937-951,共15页China Cancer

基　　金：中国博士后科学基金资助项目(2023M743126);健康浙江百万人群队列(K纵20230085)。

摘　　要：[目的]探究消化道肿瘤胃肠镜筛查依从性及其影响因素,为消化道肿瘤筛查实践提供证据支持和管理建议。[方法]基于2023年宁波市奉化区消化道肿瘤联合筛查项目,对目标人群进行消化道肿瘤风险评估,动员评估阳性人群进行胃肠镜临床筛查。采用χ^(2)检验比较不同特征人群的消化道肿瘤风险评估阳性率和临床筛查依从性,多因素Logistic回归模型分析评估阳性人群胃肠镜临床筛查依从性的影响因素。[结果]最终纳入分析对象共48587人,平均年龄(63.95±7.48)岁,其中男性占39.45%(19166人)。上消化道癌和结直肠癌风险评估阳性率分别为39.00%(18949人)和16.02%(7782人)。胃镜和结肠镜依从性分别为59.51%(11277/18949)和50.85%(3957/7782)。多因素Logistic回归分析显示:未婚、评估日期间隔超过14 d者胃镜依从性低(P均<0.05);体质指数≥24 kg/m^(2)、有胃肠道症状、上消化道疾病史、恶性肿瘤家族史、胃镜史、新鲜蔬菜水果摄入较少、加工肉类摄入较多的上消化道癌评估阳性人群胃镜依从性高(P均<0.05)。受教育程度高、评估日期间隔超过14 d者结肠镜依从性低(P均<0.05);有胃肠道症状、上消化道疾病史、加工肉类和油炸或烧烤食品摄入较多、上消化道癌风险评估为阳性的结直肠癌评估阳性人群结肠镜依从性高(P均<0.05)。[结论]消化道肿瘤联合筛查受试者临床筛查胃肠镜依从性高,胃肠镜依从性与个体生活方式、健康状况、疾病史、医疗史、肿瘤家族史等因素有关。[Purpose]To analyze the compliance rates and influencing factors for gastroscopy and colonoscopy in gastrointestinal cancer screening,and to provide evidence and management recommendations for gastrointestinal cancer screening programs.[Methods]The study was based on the joint gastrointestinal cancer screening program conducted in Fenghua District of Ningbo City in2023.The target population underwent risk assessments,following which high-risk individuals were mobilized for gastroscopy and colonoscopy screenings.Theχ^(2)test was used to compare the positive rates of gastrointestinal cancer risk assessments and the compliance rates of clinical screenings among populations with different characteristics.Multivariable Logistic regression models were applied to analyze the factors associated with compliance rates of clinical gastroscopy and colonoscopy screenings among high-risk individuals.[Results]A total of 48587 individuals were included in the analysis,with an average age of(63.95±7.48)years old.Among them,39.45%(19166individuals)were male.The positive rates of risk assessment for upper gastrointestinal cancer and colorectal cancer were 39.00%(18949 individuals)and 16.02%(7782 individuals),respectively.The compliance rates for gastroscopy and colonoscopy were 59.51%(11227/18949)and 50.85%(3957/7782),respectively.Multivariable Logistic regression analysis revealed that unmarried individuals and those with an assessment interval of more than 14 d had lower compliance with gastroscopy(both P<0.05).High-risk individuals for upper gastrointestinal cancer with BMI≥24 kg/m^(2),gastrointestinal symptoms,history of upper gastrointestinal diseases,family history of cancers,history of gastroscopy,lower intake of fresh vegetables and fruits,and higher intake of processed meats had higher compliance with gastroscopy(all P<0.05).High educational levels and an assessment interval of more than 14 d were associated with lower compliance with colonoscopy(both P<0.05).Among individuals at high risk for colorectal cancer,those w

关 键 词：消化道肿瘤 筛查 内镜 依从性 影响因素 

分 类 号：R73-31[医药卫生—肿瘤] R735[医药卫生—临床医学]