松江区居民大肠癌筛查及检查顺应性的影响因素分析

An analysis on the influencing factors of compliance in colorectal cancer screening among residents in Songjiang District

目的研究居民大肠癌筛查结果及其检查顺应性的影响因素,为提高大肠癌的筛查效果提供依据。方法 2012—2013年选择上海市松江区40岁以上的大肠癌高危人群140 096人进行粪便潜血试验(FOBT),FOBT阳性者进行肠镜检查。同时对所有人群进行问卷调查,分析其对肠镜检查的应答情况,并分析对肠镜检查顺应性的影响因素。结果 FOBT阳性率为16.83%。肠镜检查8 566人,筛查率36.33%。诊断肠癌142例,检出率为1.66%。FOBT阳性率2013年15.78%与2012年18.16%比较,明显降低(P<0.05),且肠镜检查率明显升高(45.66%,26.04%,P<0.05)。多因素非条件Logistic回归分析显示,怕痛(OR=3.01)、认为没必要(OR=1.89)是肠镜检查顺应性的独立不利因素,而文化程度高(OR=0.92)、定期体检(OR=0.75)是肠镜检查顺应性的有利因素(P<0.05)。结论松江区居民大肠癌筛查的顺应性不高,定期体检、文化程度高的高危人群更容易接受肠镜检查,怕痛、认为没必要是拒绝肠镜检查的主要原因。

Objective To explore the influence factors of the compliance in colorectal cancer（ CRC）screening. Methods A total of 140 096 local people were selected for fecal occult blood test（ FOBT）in Songjiang District Shanghai City. They were over 40 years old and thought to be high risk groups of colorectal cancer. The participants with FOBT positive were asked to following colonoscopy. All the participants were interviewed by a questionnaire. The influencing factors of compliance on colorectal cancer screening were analyzed by multivariate regression. Results Of all the residents with high risk of colorectal cancer,The FOBT positive rate was 16. 83%. Of the FOBT positive residents,8 566 cases took the examination of colonoscopy,and the screening rate was 36. 33%. A total of 142 cases were diagnosed as colorectal cancer, with the detection rate of 1. 66%. Compared with the positive rate of FOBT in 2012 and 2013,the rate was significantly lower（18. 16%,15. 78%,p〈0. 05）,and the rate of colonoscopy examination increased（45. 66%,26. 04%,p〈0. 05）. Multivariate logistic regression showed that fear of pain（ OR=3. 01 ）,the thought of uselessness（ OR=1. 89 ）were risk factors for compliance in colorectal cancer screening（ p 〈0. 05 ）. Conclusion The compliance of colorectal cancer screening in Songjiang District is relatively low. High-risk groups with regular physical examination,high level education were prone to have good compliance,and fear of pain,think it useless were the main reason for incompliance.