上海市社区居民大肠癌筛查分析

目的了解上海社区市民大肠癌筛查情况。方法对1000名符合筛查条件的居民由社区卫生服务中心使用《上海市社区居民大肠癌筛查危险度评估表》开展大肠癌患病风险评估,并进行大便隐血试验（FOBT）,对问卷结果和FOBT结果进行分析。结果 1000名居民中,女性560人,占总数56%;男性440人,占总数44%;评价高危险度的人占总样本的11.6%,其中男性55人,女性61人;FOBT检查为阳性的总样本的占2.8%;在这些人中患慢性疾病以及有一级亲属遗传史的比例明显高于普通人,男女差异无统计学意义,但患病可能性却与年龄呈现高相关;慢性便秘史、黏液血便史以及直系家庭癌症史与FOBT检验结果差异有统计学意义,OR值分别为4.38（95%CI：1.71-11.21,P〈0.05）,8.86（95%CI：2.37-32.96,P〈0.05）和4.89（95%CI：1.60-14.91,P〈0.05）。结论即使在危险评估中显示阴性的人群,仍有FOBT检查为阳性的可能性,大肠癌筛查工作中不能掉以轻心,同时对于检查为阴性的人群同样需要进行相关的预防和健康教育干预。

Analysis of colorectal cancer screening among urban residents in Shanghai community

Objective To understand colorectal cancer screening results among urban residents in Shanghai community.Methods A questionnaire survey,＂Shanghai community resident＇s risk of colorectal cancer screening evaluation table＂,and FOBT were used for screening colorectal cancer risk assessment among 1000 eligible residents in community health service centers.Results There were 560 females（56%） and 440 males（44%） in interviewed 1000 persons,11.6% of the respondents were at high risk,in that there were 55 males and 61 females,and 2.8% of the respondents were FOBT positive.Among those populations,respondent who was suffering chronic diseases,or who had a genetic-relative cancer history,would have a significantly higher risk than that of ordinary people.No difference was found between men and women,but possibility of colorectal cancer was highly related with age.People who had high positive rate of FOBT were those suffering chronic constipation（OR = 4.38,95% CI： 1.71-11.21,P〈0.05）,mucous bloody stool（OR = 8.86,95% CI： 2.37-32.961,P〈0.05） and who had a genetic-relative cancer history（OR = 4.89,95% CI： 1.60-14.91,P〈0.05）.Conclusion Even people got negative risk assessment of colorectal cancer,there still have positive possibility in FOBT,we must pay more attention to colorectal cancer screening work and its prevention work.