文章摘要
李燕,刘华章,梁颖茹,林国桢,李科,董航,许欢,王鸣.广州市2015-2016年50~74岁社区人群大肠癌筛查结果分析[J].中华流行病学杂志,2018,39(1):81-85
广州市2015-2016年50~74岁社区人群大肠癌筛查结果分析
Analysis of community colorectal cancer screening in 50-74 years old people in Guangzhou, 2015-2016
收稿日期:2017-06-28  出版日期:2018-01-13
DOI:10.3760/cma.j.issn.0254-6450.2018.01.017
中文关键词: 大肠癌;筛查;早诊早治
英文关键词: Colorectal neoplasm;Screening;Early diagnosis and treatment
基金项目:广州市科技计划项目(201707010205)
作者单位E-mail
李燕 510440 广州市疾病预防控制中心  
刘华章 510440 广州市疾病预防控制中心  
梁颖茹 510440 广州市疾病预防控制中心  
林国桢 510440 广州市疾病预防控制中心  
李科 510440 广州市疾病预防控制中心  
董航 510440 广州市疾病预防控制中心  
许欢 510440 广州市疾病预防控制中心  
王鸣 510440 广州市疾病预防控制中心 wangming@gzcdc.org.cn 
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中文摘要:
      目的 分析广州市开展现行大肠癌筛查策略的效果。方法 收集、整理2015-2016年广州市大肠癌筛查数据,评价问卷调查、便隐血检查和全结肠镜检查的筛查效果。结果 2015-2016年广州市50~74岁重点人群完成初筛220 834人,初筛阳性37 040例(16.77%)。全结肠镜检7 821人,肠镜检查顺应率为21.12%(7 821/37 040)。发现各类肠道病变4 126例(52.76%),其中进展性腺瘤614例(7.85%)、伴中/重度异型增生的其他病变73例(0.93%),大肠癌230例(2.94%);各类病变中男性检出率均高于女性(P<0.01)。病变早诊率为87.24%;筛查发现早期癌99例,占总大肠癌的46.26%。大肠癌筛查发现率为104.15/10万,明显高于相应年龄段(50~74岁)大肠癌监测发病率81.18/10万(P<0.001),表现为≤69岁年龄段大肠癌发现率明显高于相应发病率,≥70岁年龄段则相反。结论 广州市大肠癌筛查策略可以发现大肠癌高危人群,提高全结肠镜病变检出率、癌前病变早诊率和早期大肠癌的诊断比例,≤69岁人群受益高于70~74岁人群,是大肠癌筛查重点关注人群,应需进一步促进高危人群肠镜检查顺应性。
英文摘要:
      Objective To analyze the effect of colorectal cancer screening in the general population in Guangzhou, and provide evidence for the for development of colorectal cancer screening policy and strategy. Methods The data of colorectal cancer screening in Guangzhou during 2015-2016 were collected. The participation, the positive rate of fecal occult blood test, the detection rate of colonoscopy and screening effect of colonoscopy were evaluated. Results A total of 220 834 residents aged 50 -74 years received the screening, and the positive rate of the screening was 16.77% (37 040 cases). Colonoscopy was performed for 7 821 cases (21.12%). Colorectal lesions were found in 4 126 cases (52.76%), of which 614 (7.85%) and 73 (0.93%) and 230 (2.94%) were identified as advanced adenoma, severe dysplasia lesions and colorectal cancers, respectively. The detection rates of all colorectal lesions were higher in men than in women (all P<0.01). The diagnostic rate of early lesion was 87.24%, and 99 early cancer cases were found, accounting for 46.26% of the total cases. The overall screening detection rate of colorectal cancer was 104.15/100 000, higher than the incidence rate (81.18/100 000) in colorectal cancer surveillance (P<0.001), but age group <70 years had higher detection rate, age group ≥ 70 years had higher incidence rate. Conclusions The colorectal cancer screening strategy in Guangzhou is effective in the detection of the population at high risk, increase the detection rate of colorectal lesions, early diagnosis rate of precancerous lesions and diagnosis rate of early colorectal cancer. The benefit in those aged ≤ 69 years was more obvious than that in those aged 70-74 years. It is necessary to improve the compliancy of colorectal cancer screening in population at high risk.
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