2013—2018年安徽省淮河流域胃癌高危人群内镜筛查参与率及其影响因素分析

目的 研究2013—2018年安徽省淮河流域胃癌高危人群的内镜筛查参与率，探讨可能的影响因素。方法 2013—2018年，在安徽省淮河流域癌症早诊早治项目覆盖的6个地区，采用整群抽样方法，面向40~69岁常住居民，进行健康因素问卷调查和胃癌风险评估，对评估出胃癌高危人群进行内镜筛查，采用χ²检验比较不同特征对象内镜筛查参与率的差异，采用多因素logistic回归模型分析内镜筛查参与率的影响因素。结果 共纳入胃癌高危人群70 927人，其中32 170人接受内镜筛查，总体参与率为45.36%。内镜筛查的参与率存在着显著的时间（χ² = 651.193，P＜0.001）和地区（χ² = 4 799.975，P＜0.001）差异。多因素logistic回归分析显示，女性（OR = 1.27，95%CI:1.22～1.32）、年龄偏大（50～59岁:OR = 1.29，95%CI:1.24～1.34；60～69岁:OR = 1.37，95%CI:1.32～1.43）、大专及以上学历（OR = 1.66，95%CI:1.46～1.90）、离异（OR = 1.43，95%CI:1.27～1.62）、丧偶（OR = 1.12，95%CI:1.03～1.23）、家庭年均收入高（＞10 000～30 000元:OR = 1.46，95%CI:1.41～1.52；＞30 000～50 000元:OR = 1.43，95%CI:1.36～1.50；＞50 000元:OR = 1.24，95%CI:1.16～1.31）、饮用未处理水源（浅表水:OR = 1.33，95%CI:1.27～1.38；深井水/泉水:OR = 1.31，95%CI:1.24～1.37）、不吸烟（OR = 1.27，95%CI:1.21～1.33）、不饮酒（OR = 1.17，95%CI:1.11～1.22）、有消化系统疾病史（1种:OR = 1.32，95%CI:1.27～1.37；2种:OR = 1.93，95%CI:1.81～2.06；3种及以上:OR = 2.47，95%CI:2.17～2.81）和有胃癌家族史（OR = 1.27，95%CI:1.17～1.37）的人群接受内镜筛查参与率较高。结论 胃癌高危人群内镜筛查参与率仍有待提高，研究结果将为今后制定有效的基于人群的胃癌筛查策略提供重要参考。

Participation rate and related factors of endoscopy screening for gastric cancer among high-risk population in Huai River basin of Anhui Province from 2013 to 2018

Objective To investigate the participation rate of endoscopic screening in the high-risk population of gastric cancer in the Huai River basin of Anhui Province from 2013 to 2018 and to explore the possible influencing factors. Methods From 2013 to 2018, health factor questionnaires and gastric cancer risk assessment were conducted in six regions covered by the early diagnosis and treatment of cancer project in the Huai River basin of Anhui Province, using a whole-group sampling method for permanent residents aged 40 to 69 years old, and endoscopic screening was performed among the assessed high-risk population for gastric cancer. The χ²test and multivariate logistic regression were used to analyze related factors of the participation rate of endoscopy screening. Results A total of 70 927 people with high risk of gastric cancer were included, of whom 32 170 received endoscopic screening, with an overall participation rate of 45.36%. There was significant temporal (χ²= 651.193, P<0.001) and regional (χ²=4 799.975, P<0.001) differences in the participation rate of endoscopic screening. Multifactorial logistic regression analysis showed that females (OR=1.27, 95%CI: 1.22 -1.32), older age (50 to 59 years: OR=1.29, 95%CI: 1.24-1.34; 60 to 69 years: OR=1.37, 95%CI: 1.32-1.43), college and higher education (OR=1.66. 95%CI: 1.46-1.90), divorced (OR=1.43, 95%CI: 1.27-1.62), widowed (OR=1.12, 95%CI: 1.03 to 1.23), high average annual household income (> 10 000 yuan to 30 000 yuan: OR=1.46, 95%CI: 1.41-1.52; > 30 000 yuan to 50 000 yuan: OR=1.43, 95%CI: 1.36-1.50; >50 000 yuan: OR=1.24, 95%CI: 1.16-1.31), drinking from untreated water sources (shallow surface water: OR=1.33, 95%CI: 1.27-1.38; deep well/spring water: OR=1.31, 95%CI: 1.24-1.37), and non-smoker (OR=1.27, 95%CI: 1.21-1.33), non-drinker (OR=1.17, 95%CI: 1.11-1.22), history of digestive disorders (one kind: OR=1.32, 95%CI: 1.27-1.37; two kinds: OR=1.93, 95%CI: 1.81-2.06; three kinds and more: OR= 2.47, 95%CI: 2.17-2.81) and those with a family history of gastric cancer (OR=1.27, 95%CI: 1.17-1.37) had a higher participation rate in receiving endoscopic screening. Conclusion The participation rate of endoscopic screening in high-risk groups of gastric cancer still needs to be improved, and the results of the study provide an important reference for the development of effective population-based gastric cancer screening strategies in the future.