大肠癌优化序贯筛查方案的应用研究

Optimization of sequential screening scheme in prevention of colorectal neoplasm

目的:在人群中应用大肠癌优化序贯筛查方案,提高大肠癌的早诊率,降低发病率。方法:采用数量化风险评估问卷调查加粪便隐血试验(FOBT)对40~74岁人群进行初筛,确定高危人群并进行电子肠镜全结直肠检查。根据筛查结果计算早诊率,分析筛查区大肠癌的发病率,并与筛查前比较。结果:现场应用优化序贯筛查方案,检出各类大肠病变1 117例,其中检出大肠癌69例,大肠腺瘤701例,进展期腺瘤211例;大肠癌早诊率提高了58.19%,发病率下降明显。结论:大肠癌优化序贯筛查方案简便、经济、高效,值得在自然人群大肠癌筛检中推广。

Objective:To improve early diagnosis rate and reduce the incidence rate of colorectal cancer,through the application of optimized sequential screening scheme for colorectal neoplasm in general population.Methods:Quantitative risk assessment by questionnaires survey and fecal occult blood test(FOBT) were used to proceed preliminary screening among people aged 40 to 74.Electronic colonoscopy was applied to examine the whole colon and rectum among identified high-risk subjects.The detected cases received treatment for colorectal cancer,adenomatous polyps or non-adenomatous polyps.The early diagnosis rate and incidence rate of colorectal cancer were evaluated and compared with those before screening.Results:With application of optimized sequential screening schemes,various types of colorectal lesions were detected in 1 117 subjects,including 69 cases of colorectal cancer,701 cases of colorectal adenoma and 211 cases of advanced adenoma.The early diagnosis rate of colorectal cancer was increased by 58.19%,and its incidence rate also decreased significantly.Conclusion:The optimized sequential screening scheme is simple,economical,efficient in colorectal cancer screening of general population.