江苏省扬中市40～69岁高危人群食管癌筛查结果分析

目的 了解江苏省扬中市40～69岁高危人群食管癌发病情况。方法 2011-2017年运用整群随机抽样的方法，在江苏省扬中市食管癌高发区选取部分自然村，以其中40～69岁户籍居民作为目标人群，共筛查14 687人次，经内窥镜检查和病理学诊断食管癌。结果 筛查共发现341人患有食管癌前病变，检出率为2.32%（341/14 687），其中轻度异型增生234人（1.59%）、中度异型增生107人（0.73%）。食管癌阳性病例77人，检出率为0.52%，其中重度异型增生和（或）原位癌41人（0.28%）、早期癌19人（0.13%）、中晚期癌17人（0.12%）。筛查早诊率为77.92%（60/77），呈先上升后下降趋势。食管各级病变检出率男性高于女性（P<0.05），但男女性早期癌和中晚期癌检出率差异无统计学意义（P>0.05）。除中晚期癌症外，各级食管病变检出率均随着年龄的增长而增加（P<0.05），中晚期癌检出率在60～岁年龄组达到最高（0.39%，10/2 547），65～岁组略有下降。结论 食管癌筛查项目能够在高危人群中发现相当数量的癌症及癌前病变患者，对改善患者生存率和生存质量意义重大。同时应当重视高危人群中的男性和老年群体，以此提高食管癌早期病例的检出率。

Efficacy of esophageal cancer screening program on population at high risk: a survey carried out in people aged 40-69 years in Yangzhong, Jiangsu province

Objective To understand the incidence of esophageal cancer in population at high risk in Yangzhong of Jiangsu province. Methods Cluster random sampling method was conducted to select several natural villages from the high risk area of esophageal cancer in Yangzhong during 2011-2017. Local residents aged 40-69 years were selected as the target population and a total of 14 687 persons were diagnosed esophageal cancer by endoscopy and pathology. Results Precancerous lesions were detected in 341 persons, with the detection rate as 2.32% (341/14 687). Among them, there were 234 (1.59%) cases with mild and 107 (0.73%) cases with moderate esophageal hyperplasia. There were 77 positive cases with esophageal hyperplasia and the detection rate was 0.52%. Among these positive cases, 41 showed severe esophageal hyperplasia/carcinoma in situ (0.28%), with another 19 as early esophageal cancer (0.13%) and 17 with invasive carcinoma (0.12%). The overall early detection rate of positivity through active screening was 77.92% (60/77), with trends of upwarding and then downwarding. The detection rate of esophageal lesions in men was higher than that in women (P<0.05), but without significant gender specific differences seen in the detection rates of early esophageal cancer or invasive carcinoma (P>0.05). The detection rates of all lesions other than invasive carcinoma, gradually increased with age (P<0.05). The detection rate of invasive carcinoma reached the highest (0.39%, 10/2 547) in the age group of 60-years and slightly decreased in the age group of 65-years old. Conclusions Considerable numbers of patients with cancer and precancerous lesions in groups at high-risk can be found through the screening program for esophageal cancer, suggesting that the screening program is of great significance in improving the survival rate and quality of life. Attention should be paid to men, with elderly groups in particular, at high-risk in order to increase the detection rate of early cases.