上海某社区人群大肠癌伺机性筛查结果分析

Analysis of opportunistic screening results for colorectal cancer in a Shanghai community

目的了解社区人群大肠癌危险因素现况，验证分析序贯模式的伺机性筛查效率。方法上海欧阳社区50～85岁常住居民问卷调查和粪便潜血试验（FOBT）初筛，阳性者行肛指、血清肿瘤标记物和结肠镜精筛。结果1206人完成初筛，FOBT总阳性率4％（45／1206），评估为高危176人，阳性率15％，均接受后续精筛，结肠镜顺应率100％。结肠息肉检出率9％（15／176），大肠癌检出率5％（8／176），其中结肠癌5例（63％），直肠癌3例（37％）。结论社区人群大肠癌高危因素聚焦在遗传背景、腹型肥胖和体力活动缺乏。序贯模式的伺机性筛查顺应性好、效率高、成本低，适合社区人群大肠癌筛查应用。

Abstract：Objective To explore the current status of colorectal cancer risk factors of community population, verify and analyze the efficiency of opportunistic screening by sequential mode. Methods The residents aged 50 to 85 years from Shanghai Ouyang community were selected to answer questionnaire and received fecal occult blood test（FOBT）. The per- sons with a positive result in the preliminary screening would receive a follow-up screening, including rectal examination, serum tumor markers and colonoscopy. Results Total 1206 persons completed preliminary screening, the total positive rate of FOBT was 4% （45/1206）, 176 objects were high-risk by assessment,positive rate was 15% ,all of them received follow-up screening, compliance rate of colonoscopy was 100%. Detection rate of colonic polyps was 9% （15/176）, color- ectal cancer was 5% （8/176）, including 5 cases of colon cancer（63% ）, 3 cases of rectum cancer（ 37% ）. Conclusion Risk factors of colorectal cancer in community population focus on genetic background, abdominal obesity and lacking of physical activity. Opportunistic screening by sequential mode can display a good compliance, high efficiency and low cost, suitability for application in colorectal cancer screening of community population.