南京地区结直肠癌高危人群结肠镜筛查依从性及影响因素  

Compliance and factors influencing colonoscopy screen among high-risk populations for colorectal cancer in Nanjing

作　　者：尹洁 杨华[1] 滕玉芳[1] 徐桂芳[1] 于铃 李莎 王烨 YIN Jie;YANG Hua;TENG Yufang;XU Guifang;YU Ling;LI Sha;WANG Ye(Nanjing Drum Tower Hospital,Nanjing,Jiangsu 210000,China)

机构地区：[1]南京鼓楼医院,江苏南京210000

出　　处：《华南预防医学》2025年第1期25-29,共5页South China Journal of Preventive Medicine

基　　金：国家自然科学基金资助项目(82170548)。

摘　　要：目的 调查南京地区结直肠癌高危人群结直肠镜筛查依从性,并分析影响结直肠镜筛查的相关因素。方法 选择2023年1月至2024年1月在南京某三级医院消化内科门诊就诊且经结直肠癌高危因素量化问卷评估为结直肠癌高危人群的患者作为调查对象。采用描述性分析对结直肠癌高危人群评估结果及结直肠镜筛查依从情况进行分析,并采用单、多因素分析方法对筛查依从性影响因素进行分析。结果 本研究共纳入4 470例门诊就诊者,经高危评估发现结直肠癌高危人群1 098例,高危人群检出率24.56%;有394例结直肠癌高危人群进行了结直肠镜筛查,筛查依从率为35.88%。经多因素logistic回归分析,大专及以上受教育程度(OR=2.101)、家庭平均月收入水平≥4 000元(OR=1.838)、定期体检(OR=3.802)、家庭关怀度良好(OR=1.636)、一级亲属有结直肠癌病史(OR=2.599)、恶性肿瘤史(OR=5.924)、肠道息肉史(OR=2.408)、黏液血便(OR=3.293)、慢性胆道疾病史或胆囊切除史(OR=2.459)、恐惧有创检查(OR=0.421)、筛查准备工作复杂(OR=0.584)、担心筛查后风险(OR=0.495)、检查部位令人尴尬(OR=0.611)、担心检出不良结果(OR=0.442)是结直肠癌高危人群结直肠镜筛查依从性的影响因素(P<0.05或P<0.01)。结论 南京地区结直肠癌高危人群进行结直肠镜筛查依从性较低,需根据人群特点做好正确引导,加强防癌、筛查知识的宣传教育,以提高该人群结直肠镜筛查依从性。Objective To investigate the compliance of colonoscopy screening among high-risk colorectal cancer(CRC)populations in Nanjing and to analyze the factors influencing colonoscopy screening.Methods From January 2023 to January 2024,patients who visited the gastroenterology outpatient department of a tertiary hospital in Nanjing were enrolled and participated a quantified risk questionnaire survey about high-risk factors for colorectal cancer(CRC).Questionnaire evaluation results of the high-risk CRC population and their compliance with colonoscopy screening were analyzed.Factors influencing screening compliance were explored by using univariate and multivariate analysis.Results A total of 4470 outpatients were enrolled in this study,among whom 1098 were identified as having high-risk for colorectal cancer(CRC),with a detection rate of 24.56%.Of these high-risk individuals,394 underwent colonoscopy screening,yielding a screening compliance rate of 35.88%.Multivariate logistic regression analysis revealed that higher education level(college degree or above,OR=2.101),average monthly household income≥4000 RMB(OR=1.838),regular physical check-ups(OR=3.802),good family support(OR=1.636),direct relatives with a history of CRC(OR=2.599),personal history of malignancy(OR=5.924),history of intestinal polyps(OR=2.408),mucous bloody stool(OR=3.293),history of chronic biliary disease or cholecystectomy(OR=2.459),fear of invasive examinations(OR=0.421),complexity of screening preparation(OR=0.584),concern about post-screening risks(OR=0.495),embarrassment with the examination area(OR=0.611),and worry about adverse findings(OR=0.442)were significant factors influencing colonoscopy screening compliance among high-risk CRC individuals(P<0.05 or P<0.01).Conclusions The compliance with colonoscopy screening among high-risk CRC populations in Nanjing is relatively low.It is essential to provide appropriate guidance based on population characteristics and to strengthen publicity and education on cancer prevention and screening,in orde

关 键 词：结直肠癌 高危人群 结直肠镜 筛查依从性 

分 类 号：R195[医药卫生—卫生统计学]