2015—2019年广州市结直肠癌筛查不同初筛方式阳性人群肠镜结果分析

目的]分析2015—2019年广东省广州市结直肠癌筛查的数据,比较不同初筛方式阳性人群肠镜结果,以期更好地动员居民参与肠镜检查。方法]整理2015—2019年广州市结直肠癌筛查数据,将初筛阳性人群分为5组:仅高危因素问卷评估阳性(免疫化学法粪便隐血试验阴性)high risk factor questionnaire (HRFQ) positive and fecal immunochemical test(FIT)negative,HRFQ+&Double-FIT-]、HRFQ阳性和1次FIT阳性(HRFQ+&Single-FIT+)、HRFQ阴性和1次FIT阳性(HRFQ-&Single-FIT+)、HRFQ阴性和2次FIT阳性(HRFQ-&DoubleFIT+)、HRFQ阳性和2次FIT阳性(HRFQ+&Double-FIT+)。采用多元Logistic回归比较不同初筛方式阳性人群肠镜结果。结果]广州市共完成初筛403 585人,初筛阳性69 619人,初筛阳性率为17.25%,肠镜检查依从性为28.53%;HRFQ+&Double-FIT+、HRFQ-&DoubleFIT+、HRFQ-&Single-FIT+、HRFQ+&Single-FIT+组检出异常风险分别是HRFQ+&DoubleFIT-组的1.638、1.642、1.174和1.515倍,HRFQ-&Double-FIT+和HRFQ+&Single-FIT+组检出腺瘤风险分别是HRFQ+&Double-FIT-组的1.306和1.214倍,HRFQ+&Double-FIT+、HRFQ-&Double-FIT+、HRFQ-&Single-FIT+、HRFQ+&Single-FIT+检出进展性腺瘤风险分别是HRFQ+&Double-FIT-组的4.823、5.870、2.571和2.463倍,HRFQ+&Double-FIT+、HRFQ-&Double-FIT+、HRFQ-&Single-FIT+、HRFQ+&Single-FIT+检出肠癌风险分别是HRFQ+&Double-FIT-组的33.532、31.345、5.353和6.627倍。结论]广州市结直肠癌筛查肠镜检查依从性较低,应加大对结直肠癌初筛阳性人群的动员,尤其是FIT 2次阳性的人群。

Comparison of Colonoscopy Results in Participants with High Risk Assessed by Different Criteria in Colorectal Cancer Screening Program in Guangzhou,2015—2019

Purpose] To compare colonoscopy results in participants with high risk assessed by different criteria in colorectal cancer screening program in Guangzhou,2015—2019. Methods]Data of colorectal cancer screening in Guangzhou from 2015 to 2019 were collected. The high risk participants were divided into 5 groups according the primary risk assessment results:high risk questionnaire(HRFQ) positive plus two fecal immunochemical tests(FIT)negative(HRFQ+ & Double-FIT-),HRFQ positive and single FIT positive(HRFQ + & Single-FIT +),HRFQ negative and single FIT positive(HRFQ-& Single-FIT+),HRFQ negative and double FIT positive(HRFQ-&Double-FIT+),HRFQ positive and double FIT positive(HRFQ+ & double-FIT+). All high risk participants were subjected for colonoscopic examination,and the multiple Logistic regression was used to compare colonoscopy results in different groups. Results] Among total 403 585 participants,there were 69 619 identified as high risk subjects(17.25%) and the overall compliance rate of colonoscopy was 28.53%(19862/69619). The high risk rates in groups HRFQ+ & Double-FIT+,HRFQ-& Double-FIT+,HRFQ-& Single-FIT+,HRFQ+ & Single-FIT+ were 1.638,1.642,1.174 and 1.515 times higher as group HRFQ+ & Double-FIT-,respectively.The detective rates of adenoma in groups HRFQ-& Double-FIT + and HRFQ + & Single-FIT + were 1.306 and 1.214 times higher as HRFQ + & Double-FIT-,respectively. The detective rates of advanced adenomas in groups HRFQ+ & Double-FIT+,HRFQ-& Double-FIT+,HRFQ-& Single-FIT+,HRFQ+ & Single-FIT + were 4.823,5.870,2.571 and 2.463 times higher asgroup HRFQ + & Double-FIT-,respectively. The detective rates of colorectal cancerin groups HRFQ + & Double-FIT +,HRFQ-& Double-FIT +,HRFQ-& Single-FIT +,HRFQ + & Single-FIT + were 33.532,31.345,5.353 and6.627 times higher as group HRFQ + & Double-FIT-,respectively. Conclusion] The compliance rate of colonoscopy examinations for screening colorectal cancer is relatively low in Guangzhou. It is necessary to increase the compliance rate among high risk subjects,especially for those withdouble FIT positive results.