康健社区2012年大肠病变筛查结果分析

Analysis of screening for colorectal lesions in Kangjian community in 2012

目的：调查社区居民大肠病变早发状况，评估筛查方案。方法：对社区健康档案数据库中40～70岁的常住人群采用问卷调查和免疫法粪便潜血试验相结合的方法进行初筛，应用全结肠镜进行精筛。结果：筛查1011人，高危人群为363人，高危阳性率35．90％。高危人群中有156人接受全结肠镜检查，高危人群受检率为42．98％。检出大肠病变（大肠癌、息肉）87例，其中早期癌1例，大肠癌检出率为98．91／10^5。结论：单项应用诊断早期大肠癌的正确率低。问卷调查和大便隐血试验对大肠癌诊断有一定价值，适合在社区普查。

Objective： To investigate the early status of citizens in the community who are suffering colorectal lesions, and thus to test and assess the screening plan of early colorectal cancer. Methods： Combination of questionnaire method and the fecal occult blood tests （FOBT） was used for primary screening among all the residents aged from 40 to 70 in the databases for the health archive in Kangjian Community. For those whose primary screening result was positive, high risk factors on their own should be eliminated and then colonoscopy should be used for fine screening. Results： One thousand and eleven residents accepted the screening of colorectal cancer, and eventually 363 of them were confirmed as high-risk-population with positive rate of 35.90%. Later, 156（42.98%） residents in the high risk group accepted electronic colonoscopy. Among them, pathological changes of large intestine （colorectal cancer and polyp） were found in 87 cases including one case of early cancer. The positive rate of colorectal cancer was 98.91/105. Conclusion： Questionnaire survey and FOBT are both helpful to the diagnosis of colorectal cancer, but single application presents low accuracy in the diagnosis of early colorectal cancer. The combination of the two methods can improve the sensitivity of colorectal cancer screening, which is suitable for general investigation in communities.