| 刘希永,郑树,陈坤,马新源,周伦,余海,姚开颜,陈康,蔡善荣,张苏展.大肠癌序贯筛检方案在人群中应用的前瞻性评估[J].Chinese journal of Epidemiology,2000,21(6):430-433 |
| 大肠癌序贯筛检方案在人群中应用的前瞻性评估 |
| Randomized controlled trial of sequence mass screening program for colorectal cancer |
| Received:April 12, 2000 |
| DOI： |
| KeyWord: 大肠肿瘤 筛检 随机空白对照试验 死亡率 发病率 |
| English Key Word: Colorectal neoplasm Mass screening Randomized controlledtrial Mortality Incidence |
| FundProject:国家“七五”(75-61-02-17)、“八五”科技攻关项目 |
| Author Name | Affiliation | | LIU Xiyong | Cancer Institute of Zhejiang University, Hangzhou 310009, China | | ZHENG Shu | Cancer Institute of Zhejiang University, Hangzhou 310009, China | | CHEN Kun | Cancer Institute of Zhejiang University, Hangzhou 310009, China | | MA Xinyuan | 浙江省嘉善县肿瘤防治研究所 | | ZHOU Lun | Cancer Institute of Zhejiang University, Hangzhou 310009, China | | YU Hai | Cancer Institute of Zhejiang University, Hangzhou 310009, China | | YAO Kaiyan | 浙江省嘉善县肿瘤防治研究所 | | CHEN Kang | 浙江省嘉善县肿瘤防治研究所 | | CAI Shanrong | Cancer Institute of Zhejiang University, Hangzhou 310009, China | | ZHANG Suzhan | Cancer Institute of Zhejiang University, Hangzhou 310009, China |
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| Abstract: |
| 目的 建立并验证大肠癌序贯筛检方案在我国人群中应用的效果。方法 以大肠癌高发区嘉善县 1989年30岁及以上者作为目标人群,采用随机分组空白对照研究设计,以免疫法粪便潜血试验结合个体危险度隶属度函数 (AD值 )为初筛手段,纤维肠镜为复筛的序贯筛检方案。结果 经筛检后筛检人群与对照人群的大肠癌8年累积发病率分别为3.95‰ (95 %CI为3.81～4.10)和4.01‰ (95 %CI为3.86～ 4.16 ),两者差异无显著性；而大肠癌的累积死亡率则分别为2.08‰ (95%CI为1.96～2.18)和 2.44‰ (95 %CI为2.33～2.55 ),筛检人群较对照人群约下降了15%左右。其中直肠癌累积死亡率下降达31%,经生存分析筛检区直肠癌的生存率显著高于对照区 (log rank =9.01,P =0.0027)。结论 粪便潜血试验和个体危险度AD值的序贯筛检方案在人群中实施,可降低人群大肠癌的死亡率 |
| English Abstract: |
| Objective In o rder to assess the effectiveness of mass screening prog ram fo r colorectal cancer, a sequence mass screening prog ram based on RPHA-FOBT and individual quantitative risk assessment model (attributive degree value, AD) w as used and evalua ted on its effectiveness in a randomized controlled trial.Methods The residents of Jiashan county ag ed 30 years and over wererandomized to either screening o r control g roups in 1989.Participants in screening group were asked to fill in a questionnaire and to submit one paper slide with stoo l.Participants who tested positive underwent diagnostic evaluations including flexible sigmiodscopy and colo noscopy.Results Acco rding to the cancer registry of Jiashan, after initial mass screening in 1989, the 8-y ear cumulative incidence per 1 000 of colorectal cancer in screening and co ntrol groups appeared to be 3.95 ( 95 %CI 3.81-4.10) and 4.01(95% CI 3.86-4.16)respectively.There w as no significant statistieal difference betw een tw o g roups (P >0.05).Nevertheless, the 8-year cumulative mortality for colorectal cancer in screening g roup (2.08 per 1 000;95 %CI 1.96-2.18)was reduced 14.7 % comparing with the control group (2.44 per 1 000 ；95 %CI 2.33-2.55).In particular, the cumula tive mo rtality o f rectal cancer w as significantly (31.7%)lower than that in control g roup.Log-rank test showed that survival rate of rectal cancer in screening group was higher than that in controls (log-rank =9.01, P =0.002 7).Conclusions The sequential mass-screening prog ram which based on RPHA-FOBT and ADV mig ht reduce the mortality for colorectal cancer in the Chinese population |
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