Abstract
雷海科,董佩,周琦,邱五七,孙宗祥,黄慧瑶,任建松,刘国祥,白亚娜,王德斌,孙晓杰,廖先珍,郭兰伟,兰莉,刘玉琴,龚继勇,杨莉,邢晓静,宋冰冰,买玲,朱琳,杜灵彬,张永贞,周金意,秦明芳,吴寿岭,齐啸,孙校华,娄培安,蔡波,张凯,赫捷,代敏,毛阿燕,石菊芳.我国城市地区人群癌症筛查需求调查分析[J].Chinese journal of Epidemiology,2018,39(3):289-294
我国城市地区人群癌症筛查需求调查分析
Potential demand on cancer screening service in urban populations in China: a cross-sectional survey
Received:October 10, 2017  
DOI：10.3760/cma.j.issn.0254-6450.2018.03.008
KeyWord: 肿瘤  筛查  服务  需求
English Key Word: Neoplasms  Screening  Service  Demand
FundProject:国家重大公共卫生服务项目（城市癌症早诊早治项目）；WHO 2016－2017双年度合作项目（2016/664439-0）；中国医学科学院医学与健康科技创新工程；中国医学科学院中央级公益性科研院所基本科研业务费专项（2016ZX330009）；重庆市社会事业与民生保障科技创新专项（cstc2016shmszx0047）
Author NameAffiliationE-mail
Lei Haike Chongqing Cancer Institute, Chongqing 400030, China  
Dong Pei Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China  
Zhou Qi Chongqing Cancer Institute, Chongqing 400030, China qizhou9128@163.com 
Qiu Wuqi Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China  
Sun Zongxiang Harbin Center for Disease Control and Prevention, Harbin 150056, China  
Huang Huiyao National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Ren Jiansong National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Liu Guoxiang Harbin Medical University, Harbin 150081, China  
Bai Yana Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China  
Wang Debin Anhui Medical University, Hefei 230032, China  
Sun Xiaojie Center for Health Management and Policy of Shandong University, Jinan 250012, China  
Liao Xianzhen Hunan Provincial Cancer Hospital, Changsha 410006, China  
Guo Lanwei The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China  
Lan Li Harbin Center for Disease Control and Prevention, Harbin 150056, China  
Liu Yuqin Gansu Provincial Cancer Hospital, Lanzhou 730050, China  
Gong Jiyong Shandong Tumor Hospital, Jinan 250117, China  
Yang Li Guangxi Medical University 530021, China  
Xing Xiaojing Liaoning Cancer Hospital and Institute, Shenyang 110042, China  
Song Bingbing Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China  
Mai Ling The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China  
Zhu Lin Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China  
Du Lingbin Zhejiang Cancer Hospital, Hangzhou 310022, China  
Zhang Yongzhen Shanxi Provincial Cancer Hospital, Taiyuan 030013, China  
Zhou Jinyi Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Qin Mingfang Yunnan Cancer Hospital, Kunming 650118, China  
Wu Shouling Kailuan General Hospital, Tangshan 063000, China  
Qi Xiao Tangshan People's Hospital, Tangshan 063001, China  
Sun Xiaohua Ningbo No.2 Hospital, Ningbo 315010, China  
Lou Peian Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China  
Cai Bo Nantong Tumor Hospital, Nantong 226000, China  
Zhang Kai National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
He Jie National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Dai Min National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Mao Ayan Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China mao.ayan@imicams.ac.cn 
Shi Jufang National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China shijf@cicams.ac.cn 
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Abstract:
      目的 了解未参加过城市癌症早诊早治项目及其他国家级癌症筛查项目的城市社区居民对癌症筛查服务的接受意愿及对服务模式细化需求，从筛查潜在服务需求方的角度探索癌症筛查工作可持续性的影响要素。方法 基于城市癌症早诊早治项目的16个省份现场，采用方便抽样对当地40～69岁居民开展问卷调查，内容包括筛查服务需求意向等。结果 最终完成合格访谈16 394份，调查对象年龄（53.8±8.0）岁，男性占44.6%。若不考虑费用等因素，4 831名（29.5%）居民对癌症筛查服务没有需求，常见原因包括要等身体出现异常后才行动（61.8%）、所在单位已提供类似体检（36.8%）、自己不先做风险评估而直接去做筛查（33.0%）等。10 795名（65.8%）居民对癌症筛查服务有需求，但对筛查机构类型选择倾向不同：43.7%希望提供筛查的机构是综合性医院，36.5%希望是肿瘤专科医院；居民对于机构级别选择也有差异：61.4%的居民希望提供筛查的机构级别越高越好，36.4%则认为机构达到一定级别即可。关于筛查流程，61.5%未接收过筛查的居民认同“先问卷评估阳性后再临床检查”的模式。结论 大多数居民对癌症筛查服务有需求且倾向筛查机构级别越高越好。应普及癌症筛查知识宣传，并合理引导居民对筛查机构类型及级别的选择期望，建议加强基层筛查能力建设，合理分流居民对筛查机构的选择意愿。
English Abstract:
      Objective To understand the acceptance and personal demand for cancer screening service among the urban residents who had never been involved in any national level cancer screening programs in China and identify the key factors influencing the sustainability of cancer screening. Methods A questionnaire survey was conducted among the local people aged 40-69 years selected through convenience sampling in 16 provinces of China to collect the general information about their demands for the screening service and others. Results A total of 16 394 qualified questionnaires were completed. The average age of the people surveyed was (53.8±8.0) years, and men accounted for 44.6%. Without concerning the cost, 4 831 people (29.5%) had no demands for cancer screening services, the reasons are as follow:they would like to go to see doctors only when they were ill (61.8%); they had already received similar medical examinations (36.8%) and they would like to receive cancer screening directly without pre-health risk assessment (33.0%). Among the people surveyed, 10 795 (65.8%) had demands for cancer screening services, but they had choice on the screening settings, 43.7% wanted to receive the service in a general hospitals, while 36.5% would like to go to cancer-specialized hospitals. As for the level of medical institutes providing cancer screening service, 61.4% of the people surveyed would choose a higher level one, while 36.4% would choose an ordinary one. On screening procedures, 61.5% of the people surveyed would accept the mode of "clinical examination after questionnaire-assessment". Conclusion Most people surveyed had demands for cancer screening services and they would like to receive the screening services in higher level medical institutes. It is suggested to spread cancer screening know ledge, and strengthen the capability building of screening in grass root medical institutes to attract more people to receive cancer screening.
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