上海市宝山区社区居民大肠癌筛查病变影响因素分析

目的 通过对上海市宝山区大肠癌病变危险因素的研究,了解该地区居民大肠癌病变影响因素,为大肠癌防治提供参考依据。 方法 选取2013年5－12月上海市宝山区居民,完成《上海市社区居民大肠癌筛查危险度评估表》与胶体金法粪便隐血检测(fecal occult blood test,FOBT))确定初筛阳性人群中完成肠镜检查的居民共997人,采用多因素logistic逐步回归探讨大肠癌筛查病变影响因素。 结果 肠镜诊断阳性结果人数为224人(占22.47%),不同性别、学历、职业肠镜诊断阳性检出率比较,差异有统计学意义(P<0.05);多因素logistic回归结果显示,男性(OR=1.221,95%CI:1.042~1.867),教育程度越高(中学、中专及以上:OR=6.003,95%CI:1.338~31.675)的大肠癌筛查诊断更容易是阳性结果。相反,与职业为其他的人群相比,农民筛查诊断大肠癌为阳性结果的可能性更小(OR=0.039,95%CI:0.015~0.099)。 结论 上海市宝山区大肠癌筛查阳性诊断率高,年龄、性别、教育程度和职业是大肠癌筛查阳性的影响因素,早期筛查时应加强对注高危人群的宣传,提高诊断率,从而有效降低大肠癌的发病率和死亡率。

Factors affecting colorectal cancer related lesions screening among community residents in Baoshan district,Shanghai city

Objective To study the risk factors of colorectal cancer related lesions in Baoshan district of Shanghai city, and to provide a basis for prevention and treatment of colorectal cancer. Methods There were 997 individuals enrolled that completed the colonoscopy followed by Risk Assessment of Colorectal Cancer Screening among Shanghai Community Residents and positive Results of fecal occult blood test in Baoshan district, Shanghai in May-December 2013. The risk factors of colorectal cancer were determined by multi-factor logistic regression analysis. Results There were 224 cases with positive Results in the colorectal cancer screening,with the positive　rate of 22.47%. There were statistically significant differences in colorectal cancer related lesions between genders, educational levels and occupation (P<0.05). Multi-factor logistic regression analysis showed that male (OR=1.221, 95%CI:1.042-1.867) and educational level (middle school, technical secondary school or above (OR=6.003, 95%CI:1.338-31.675) were more likely to increase the risk of colorectal cancer related lesions. On the contrary, farmers were less likely to develop colorectal cancer related lesions (OR=0.039, 95%CI: 0.015-0.099) as compared with other occupational populations.
Conclusions 　The positive diagnosis rate of colorectal cancer screening was high in Baoshan district, Shanghai. Age, genders, educational levels and occupation were the factors influencing colorectal cancer related lesions. We should focus on the high risk populations in the early screening and improve the diagnosis rate so as to effectively decrease the incidence and mortality rate of colorectal cancer.