2011-2013年上海市青浦区社区居民大肠癌筛查结果和危险度评估因素分析

目的 分析2011-2013年上海市青浦区第一轮大肠癌筛查结果,为优化大肠癌筛查工作提供科学依据.方法 将2011-2013年青浦区参加大肠癌筛查的居民作为调查对象,分析阳性检出情况及检出瘤别情况,对大肠癌检出期别和危险度评估因素进行分析.结果 参加筛查的居民88,405人,总筛查阳性21,446人,阳性率为24.26%.其中,问卷评估阳性7,660人,阳性率为6.8%.接受肠镜检查的居民5,644人,其中确诊为癌的198例,腺瘤1,004人;腺瘤及中、重度异型增生合计1,047例,息肉与肠炎共计469例.检出大肠癌患者Ⅰ期127例,占全部病例的64.1%.logistic回归分析显示大肠癌的发病与6种危险因素存在相关性:有无慢性腹泻(OR=5.83,P<0.05)、有无慢性便秘史(OR=5.44,P<0.05)、有无粘液或血便史(OR=5.11,P<0.05)、有无慢性阑尾炎或阑尾切除史(OR=5.19,P<0.05)、有无慢性性胆囊炎或胆囊切除史(OR=6.04,P<0.05)和近10年来有无经历过对精神造成较大创伤或痛苦的事件(OR=5.14,P<0.05).结论 危险度评估结合FOBT可以有效地检出上海市青浦区居民大肠癌及癌前病变,对于降低大肠癌的死亡率和发病率具有重要意义.

Analysis of Screening Results and Risk Factors for Colorectal Cancer Among Community Residents in Qingpu District,Shanghai, 2011-2013

Objective To analyze the results of the first round of screening for colorectal cancer in Qingpu District of Shanghai from 2011 to 2013,to provide the scientific basis for optimizing the screening work for colorectal cancer.Methods The residents who participated in screening for colorectal cancer in Qingpu District from 2011 to 2013 were selected as the subjects of the survey.The positive detection and the detection of colorectal cancer in the community were analyzed.The detection stage and risk assessment factors of colorectal cancer were analyzed.Results There were 88,405 residents who participated in the screening.The total number of positive screeners was 21,446,with a positive rate of 24.26%.Among them,7,660 were positive in questionnaire,the positive rate was 6.8%.Among the 5,644 residents who underwent colonoscopy,198 were diagnosed with cancer,and 1,004 were diagnoses with adenoma;there were 1047 cases of adenoma and dysplasia,469 cases of polyp and enteritis.A total of 127 cases of stage I colorectal cancer were detected,accounting for 64.1%of all cases.logistic regression analysis showed that the incidence of colorectal cancer was correlated with six risk factors:chronic diarrhea(OR=5.83,P<0.05),chronic constipation(OR=5.44,P<0.05),mucus or hematochezia(OR=5.11,P<0.05),chronic appendicitis or appendectomy(OR=5.19,P<0.05),chronic cholecystitis or cholecystectomy(OR=6.04,P<0.05),and any event that causes great trauma or pain to the mind in the past 10 years(OR=5.14,P<0.05).Conclusion Risk assessment combined with FOBT can effectively detect colorectal cancer and precancerous lesions in residents of Qingpu District.It is of great significance to reduce the mortality and morbidity of colorectal cancer.