上海市吴泾社区提高大肠癌筛查依从性的探索

[目的] 探索在城市社区提高大肠癌筛查依从性，特别是精筛依从性的方法。[方法] 由社区卫生服务中心主导，通过成立筛查小组、明确合作单位、细化筛查环节、及时追踪督促、集中宣传教育、简化肠镜检查手续等方法，开展大肠癌筛查，并对筛查结果进行分析。[结果] 2012年10月1日-2013年9月30日，吴泾社区共有7 507人接受了大肠癌筛查，经大便隐血试验确定初筛阳性对象427人，初筛阳性率为5.69%。427名大肠癌初筛阳性对象中，精筛依从率为90.40%，完成肠镜检查率为88.99%，检出大肠癌5例，检出率为1.32%，检出大肠癌前期病例84例，检出率为22.11%，大肠癌病例进一步治疗率为100.00%，癌前期病例进一步治疗率为75.00%。初筛阳性对象从初筛到接到阳性通知间隔的时间中位数为4 d，精筛为10 d，大肠癌患者从精筛到完成治疗的间隔时间中位数为3 d，大肠癌前期患者为25 d。[结论] 吴泾社区采用的组织形式和工作方法有利于提高大肠癌筛查的依从性。

Exploration on improvement of the compliance of colorectal cancer screening in Wujing community of Shanghai

To explore the model and method of improving the compliance of colorectal cancer screening , especially the fine sieve compliance of colonoscopy . [ Methods ] The colorectal cancer screening in Wujing community was led by Wujing Community Health Center .For the sake of impro-ving the compliance of screening , Wujing Community Health Center established a screening team and speci-fied a neighboring general hospital as screening partner .We also used the method of refining the screening steps , tracking the result in time , simplifying the procedures of colonoscopy test and making epidemiological analysis. [Results] From October 1,2012 to September 30,2013, a total of 7 507 people in Wujing community received colorectal cancer screening , of whom 427 （5.69%） were found to be positive in fecal occult blood testing （FOBT）.And among them, 386 （90.40%） agreed to accept the colonoscopy test and finally 380 people （88.90%） finished the test.According to the results of colonoscopy test were detected 5 cancer patients （1.32%） and 84 precancerous lesion patients （22.11%）.Further treatment rate for color-ectal cancer patients was 100.00%and for precancerous lesion patients 75.00%.The median duration was 4 days for preliminary screening positive subjects from preliminary screening to receiving positive notification and 10 days for refined screening .The median duration was 3 days for colorectal cancer patients from re-fined screening to completing treatment and 25 days for early colorectal cancer patients . [ Conclusion] The model and method adopted in Wujing community is helpful to improve the compliance of colorectal cancer screening .