上海市金山区某社区大肠癌筛查效果评估

目的 评估社区大肠癌筛查工作现况,为完善大肠癌社区筛查工作提供理论参考。 方法 选取2013年5月—2015年1月期间在上海市金山区朱泾社区卫生服务中心进行大肠癌筛查的40岁以上社区居民的筛查资料,采用SPSS 19.0统计软件对这些居民的大便潜血检查结果、危险度评估结果与肠镜检查和活检的最终结果进行一致性分析。 结果 2013年5月—2015年1月期间共计7 787例辖区居民进行大肠癌社区初筛,筛出1 727例阳性,检出率22.4%;其中,大便潜血阳性1 447例,检出率为18.8%,问卷危险度评估阳性438例,阳性率为5.7%,2种方法检出的阳性重复病例为158例,重复率为9.15%。转诊818例(47.37%),确诊病例303例(37.04%),大便潜血和危险度评估确诊率分别为36.24%、39.90%。经检验,2种办法与诊断结果一致性也并不显著(P＞0.05)。 结论 我国社区目前在大肠癌初筛过程中所使用的危险度评估和大便潜血检验方法,筛查效能相当且重复率较低,这就保障了卫生资源的充分利用。多种低重复、高效度筛查指标协同配合可有效提高社区人群大肠癌筛查的早发现、早诊断,但人群转诊依从性有明显限效作用需进一步提高。 

Evaluation of Colorectal Cancer Screening based on Community in Jinshan District,Shanghai

Objective To assess the status of colorectal cancer screening based on community and to provide references for promoting community colorectal cancer screening. Methods Residents over the age of 40,who got colorectal cancer screening in Jinshan District of Shanghai Zhu Jing community health service center from May 2013 to January 2015 period,were selected for this study.Their screening information was analyzed in SPSS 19.0 environment,including the results of their fecal occult blood test,risk assessment and colonoscopy and biopsy test,as well as consistency of all results. Results A total of 7 787 samples were collected from May，2013 to January，2015.The positive rate was 22.4% for all participants,18.8%(1447) with positive fecal occult blood,5.7% (438) with positive hazard assessment,and 9.15%(158) with both positive).818 cases(47.37%) were referred.At last,303 cases (37.04%) were diagnosed with cancer,showing that 36.24% of positive fecal occult blood and 39.90% of positive hazard assessment were right.Upon examination,the two approaches’ consistency with the final diagnosis was not significant(P>0.05). Conclusion The methods of risk assessment and fecal occult blood testing were applied in Chinese communities currently in colorectal screening process,and their screening efficacy and repetition rates were fairly low,which guaranteed the full use of health resources.The joint of low repetition and high degree of synergy indicators could notably improve the detection and diagnosis of colorectal cancer.However,the residents’ compliance still needed to be improved.