河南省城市地区肝癌筛查依从性及其影响因素分析

目的评价2013—2019年河南省城市地区肝癌高危人群参与肝癌筛查的依从性,探讨可能的影响因素。方法对2013—2019年河南省城市癌症早诊早治项目覆盖的郑州市、驻马店市、安阳市、洛阳市、南阳市、焦作市、新乡市和濮阳市等8个城市中,40~74岁的城市户籍居民进行患癌风险问卷调查和肝癌风险评估,对评估出的肝癌高危人群进行甲胎蛋白(AFP)联合超声检查。采用χ2检验比较不同特征人群的肝癌筛查参与率差异,采用多因素Logistic回归模型分析肝癌筛查参与率的影响因素。结果共纳入肝癌高危居民36781人,其中17241人参与了肝癌筛查,总体参与率为46.87%。肝癌筛查的参与率存在着显著的地区和时间差异。2013—2014年度的总体筛查参与率最低,为38.14%;2014—2015年度的总体筛查参与率最高,为52.77%。焦作市的参与率最高,为62.50%;濮阳市的参与率最低,为38.59%。多因素Logistic回归分析显示,性别、年龄、教育程度、吸烟史、饮酒史、体育锻炼、慢性乙型肝炎史、慢性丙型肝炎史、脂肪肝史、胆结石症史和肝癌家族史与居民是否参与肝癌筛查有关,女性、年龄偏大、学历较高、吸烟、饮酒、体育锻炼缺乏、有慢性乙型肝炎史、有慢性丙型肝炎史、有脂肪肝史、有胆结石症史、有肝癌家族史的居民更易参与肝癌筛查(均P<0.05)。结论河南省城市肝癌高危居民的肝癌筛查参与率不足50%。针对肝癌高危人群采取相应的干预措施,可能会在将来的城市居民肝癌筛查中提升筛查的依从性。

Compliance rate and impact factor analysis of liver cancer screening in urban areas of Henan Province

Objective To evaluate the compliance rate and its impact factors of liver cancer screening for high-risk groups in urban areas of Henan Province from 2013 to 2019.Methods Residents of 40-74 years old in 8 cities of Henan province were selected to investigate the risk factors and liver cancer risk assessment.Subjects with high risk of liver cancer received AFP combined ultrasonography for screening.Chi-square tests were used to compare the differences in liver cancer screening participation rates between groups.Multivariate logistic regression models were applied to explore the potential factors correlating to the compliance of liver cancer screening.Results Overall,36781 participants who met the inclusion criteria were included in this analysis,and 17241 of them took the following liver cancer screening,yielding a participation rate of 46.87%.The participation rate varied greatly across cities,ranging from 62.50%to 38.59%.Moreover,the participation rate varied greatly across periods,ranging from 52.77%in 2014-2015 to 38.14%in 2013-2014.The multivariate Logistic regression analyses showed that:female,older,high education degree,cigarette and alcohol intake,infrequent physical exercise,chronic hepatitis B,chronic hepatitis C,fatty liver,gallstones and a family history of liver cancer were inclined to accept liver cancer screening(P<0.05).Conclusions The overall participation rate of liver cancer screening among high-risk population is less than 50%in urban areas of Henan Province.Implement of effective interventions targeting the specific high-risk populations might improve the overall compliance rate of liver cancer screening in the future.