摘要
目的评价现行结直肠癌筛查方案的肿瘤检出率，探讨方案的应用价值。方法筛查目标为2007-2009年杭州下城区和嘉善县40～74岁户籍人口，共43713名。先进行由问卷调查与大便潜血检测组成的初筛，阳性者进行结肠镜诊断性复筛，发现息肉样病变即取活检或摘除，病理确诊。分析筛查数据，计算初筛阳性人群（高危人群）中不同年龄段和不同性别人群的肿瘤检出率。结果初筛认定结直肠癌高危人群6489名，占14．85％。共有完成结肠镜检查4701名，检出结直肠肿瘤569例，检出率为12．10％（95％CI：11．17％-13．04％）。其中结直肠癌52例，检出率1．11％（95％CI：0．81％-1．41％）；进展期腺瘤（183例）和非进展期腺瘤（334例）检出率分别为3．89％（95％CI：3．34％～4．45％）和7．10％（95％CI：6．37％-7．84％）。70～74岁男性肿瘤检出率最高，为22．81％（95％CI：16．98％-28．70％）；40～44岁女性中检出率最低，为2．49％（95％CI：0．79％～4．20％）。结论我国现行结直肠癌人群筛查方案的应用效果较好，但方案仍需进一步完善。
Objective To evaluate a colorectal cancer screening program by tumor detection rate and discussing its application values. Method In total,43 713 subjects were recruited in the screening program who were the registered people aged 40 - 74 in Xiacheng and Jiashan during year 2007 - 2009. The first screening involved questionnaire survey of colorectal cancer related risk factors and fecal occult blood test （FOBT）, colonoscopy was performed when a positive result was observed in the first screening. If polyps were found during colonoscopy, biopsy and pathological diagnosis were carried out. The screening data were analyzed and the tumor detection rate was calculated according to age or sex. Results 6489 subjects （ 14. 85% ） belonged to the high risk group of colorectal cancer in the first screening,in which 4701 subjects finished complete colonoscopy. Finally, 569 colorectal neoplasm were diagnosed, the detection rate was 12. 10% （95% C[： 11.17% - 13.04% ） . It included 52 colorectal cancer （ 1.11% , 95% CI： 0. 81% - 1.41% ） , 183 advanced adenoma （ 3.89% , 95% CI： 3.34% - 4. 45% ） , 334 non-advanced adenoma （7.10% ,95% CI： 6. 37% -7.84% ）. The highest detective rate was observed in male group that aged 70 - 74 （22. 81% ,95% C I： 16. 98% -28.70% ）,the lowest detective rate was observed in female group aged 40 - 44 （ 2.49% , 95% CI： 0. 79% - 4. 20% ）. Conclusion The current colorectal cancer screening program in China works well, but the revision of the program is necessary.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2011年第7期601-604,共4页
Chinese Journal of Preventive Medicine
基金
国家“十一五”科技支撑计划（2006BA102A08）志谢本研究嘉善县部分数据来自卫生部癌症早诊早治专家组和中国癌症基金会牵头的卫生部大肠癌早诊早治项目.研究得到卫生部疾病预防控制局,浙江省卫生厅疾病预防控制处,中国癌症基金会以及嘉善县和杭州下城区卫生行政部门的大力支持
关键词
结直肠肿瘤
早期诊断
普查
方案评价
Colorectal neoplasms
Early diagnosis
Mass screening
Program evaluation
