2014—2018年河南省农村癌症早诊早治项目地区人群食管癌筛查效果分析

目的:分析2014—2018年河南省农村上消化道癌早诊早治项目食管癌筛查结果。方法:根据农村上消化道癌早诊早治项目要求，在河南省农村食管癌高发地区的16个县/县级市，从2014年7月至2019年6月，以乡/村为单位进行整群抽样，纳入符合标准的40~69岁人群作为初筛人群，采用内镜碘染色及指示性活检方法开展人群食管癌筛查...

Analysis of the effects of esophageal cancer screening in Henan rural areas with cancer screening program,2014-2018

Objective To analyze the effects of esophageal cancer screening in Henan rural areas with cancer screening program from 2014 to 2018.Methods From July 2014 to June 2019,according to the National Early Diagnosis and Treatment of Upper Gastrointestinal Cancer in Rural Areas Project,cluster sampling method was adopted in 16 counties/county-level cities in rural areas with high incidence of esophageal cancer in Henan province.Endoscopic iodine staining and indicative biopsy were used to screen esophageal cancer.The patients with mild and moderate dysplasia confirmed in screening were followed up.The distribution of esophageal diseases in the screening population was calculated,and Chi-square test was used to compare the differences of detection rate and early diagnosis rate between the primary screening population and the follow-up population.Results The age of 116630 primary screening population was(54.29±7.70)years old,and the proportion of males was 41.2%(48108).In the primary screening population,patients with normal esophagus,mild to moderate dysplasia,severe dysplasia and above accounted for 92.91%(108363),6.03%(7035)and 1.06%(1232),respectively.The detection rate of esophageal cancer was 1.06%(1232/116630),and the rate of early diagnosis was 85.80%(1057).Among the follow-up population of 6154 people,those with normal esophagus,mild to moderate dysplasia,severe dysplasia and above diseases accounted for 63.45%(3905),33.13%(1519)and 3.41%(210),respectively.The detection rate of esophageal cancer was 3.41%(210/6154),and the rate of early diagnosis was 91.90%(1939).Compared with the primary screening population,the risk of esophageal cancer was higher in the overall follow-up population,people either with mild or with moderate dysplasia diagnosed in primary screening,with OR values(95%CI)of 3.23(2.78,3.75),1.85(1.49,2.29)and 8.13(6.69,9.88),respectively.Conclusion From 2014 to 2018,in the early diagnosis and early treatment of upper digestive tract cancer project in rural areas of Henan Province,the detection rate of the follow-up population is significantly higher than that of the primary screening population.Improving follow-up rate and paying more attention to the screening of people who need follow-up could further improve the screening effect.