某部40岁以上1208例体检人群大肠癌筛查结果分析

Investigation of colorectal cancer screening in people over 40 at a military unit

目的探索与体检相结合的大肠癌筛查工作的可行性。方法选择某部40岁以上人群1208例,通过宣传手段使其了解大肠癌的危险因素,发放便潜血标本收集器,对便潜血试验阳性和有危险因素的高危人群进行肠镜检查。结果在1208例筛查人员中,同时行便潜血检查和参加危险因素调查者1045例,筛查的总应答率86.5%,肠镜检查的应答率72.7%,均高于国内几次大型筛查的应答率(P<0.05)。潜血阳性组行肠镜检查21例,危险因素调查阳性组行肠镜检查83例;两组的肠镜检查应答率、肠镜检查阳性率、癌的检出率、伴不典型增生的检出率相比差异无统计学意义,潜血阳性组绒毛状腺瘤、多发管状腺瘤的检出率高于危险因素调查阳性组(P<0.05),危险因素调查阳性组单发管状腺瘤的检出率高于潜血阳性组(P<0.05)。结论与单位体检相结合的大肠癌筛查方案人群应答率高,危险因素调查是大肠癌筛查的有效手段。

Objective To evaluate the feasibility of colorectal cancer screening being combined with the annual physical ex- amination in a military unit. Methods A total of 1208 people aged 40 and above received fecal occult blood test and questionnaires. Those tested positive and at risk underwent colonoscopy. Results 1045 of these people received both FOBT and the risk factor survey, the response rate being 86.5%. 25 people got positive results in FOBT, 21 underwent eolonoscopy, 118 people got positive results in the risk factor survey and 83 people underwent colonoscopy. There was no statistical difference between the two groups in the response rate of colonoscopy,positive rate of colonoscopy, detection rate of cancer,or detection rate of ademoma with atypical hyperplasia. The detection rate of villous adenoma and multiple tubular adenoma was higher in FOBT positive group than in survey group （ P 〈 0.05 ） while the detection rate of solitary adenoma was higher in survey group than in FOBT positive group （ P 〈 0.05 ）. Conclusion The re- sponse rate is higher in the protocol of colorectal cancer screening accompanied by annual physical examinations. The risk factor survey is an efficient method in eolorectal cancer screening.