1990例社区结直肠癌筛查高危人群的结肠镜检查结果分析

Analysis on colonoscopic results of screening 1 990 community people with high-risk of colorectal cancer

目的了解上海市社区人群的结直肠癌患病情况，探讨对社区居民进行结直肠癌筛查的必要性。方法选取2013年4月至2014年9月参加上海市结直肠癌筛查，发现粪隐血试验阳性和（或）结直肠癌高危因素调查表评价为高危因素者进行结肠镜检查，共纳入1990例，对其结肠镜检查结果进行回顾性分析。统计学分析采用卡方检验。结果1990例结肠镜检查者的年龄为50～92岁，其中结盲肠息肉，结盲肠痛和类痛共有1027例，煎体榆出率为51．6％．结盲肠息肉的检出率为48．7％（969／1990），结直肠息肉最大径约为3．5cm。男性的结直肠息肉检出率为59．3％（532／897），高于女性的40．0％（437／1093），差异有统计学意义（x2=73．7，P〈0．01）。50～〈60岁、60～〈70岁、70～〈80岁、≥80岁组的结直肠息肉检出率分别为37．5％（139／371）、48．7％（524／1075）、55．9％（248／444）、58．0％（58／100），差异有统计学意义（x2=31．3，P〈0．01）。结直肠癌的检出率为2．7％（54／i990），男性的结直肠癌检出率为3．8％（34／897），高于女性的1．8％（20／1093），差异有统计学意义（x2=7．2，P〈O．05）。50-〈60岁、60-〈70岁、70-80岁、≥80岁组的结直肠癌检出率分别为1．6％（6／371）、1．9％（20／i075）、4．3％（19／444）、9．0％（9／100），差异有统计学意义（x2=23．7，P〈0．01）。直肠类癌的检出率为0．2％（4／1990）。结论上海社区结直肠癌筛查高危人群的结直肠息肉及结直肠癌的发病率高，采用序贯筛查方法对≥50岁的社区人群进行结直肠癌筛查具有重要意义。

Objective To investigate the prevalence of colorectal cancer in community people in Shanghai, and clarify the necessity of colorectal cancer screening in community residents. Methods From April 2013 to September 2014, colonoscopy examination was carried out in people who participated in colorectal cancer screening in Shanghai with positive result of fecal occult blood test or with high-risk in colorectal cancer evaluated with the risk factors questionnaire. A total of 1 990 individuals were recruited. The colonoscopic results of them were retrospectively analyzed. Chi-square test was performed for statistical analysis. Results The 1 990 individuals received colonoscopy examination aged from 50 to 92. Among the 1 990 individuals with colonoscopy examination, colorectal polyps, colorectal cancer and carcinoid were found in 1 027 cases, and the total detection rate was 51.6%. The detection rate of colorectal polyps was 48.7% （969/1 990）, and the maximum diameter of polyps was 3.5 cm. The detection rate of colorectal polyps of the male was 59.3% （532/897）, which was higher than that of the female （40.0 %, 437/1 093）, and the difference was statistically significant （2 -73.7, P〈0.01）. The detection rate of eoloreetal polyps in group 50 to 60 （not include 60） years old, 60 to 70 （not include 70） years old, 70 to 80 （not include 80） years old and ~80 years old was 37.5M （139/371）, 48.7% （524/1 075）, 55.9% （248/444） and 58.0% （58/100）, respectively. The difference was statistically significant （%2 =31.3, P〈0.01）. The detection rate of eolorectal cancer was 2.7M （54/1 990）. The detection rate of male rectal cancer was 3.8% （34/897）, which was significantly higher than that of female （1.8%, 20/1 093） ,and the difference was statistically significant （x2 = 7.2, P〈0.05）. The detection rate of colorectal cancer in group 50 to 60 （not include 60） years old, 60 to 70 （not include 70） years old, 70 to 80 （not include 80） years old and ≥80 years old was 1.6% （6/371） ,1.9% （20/1 075）, 4.3% （19/444） and 9.0% （9/100）, respectively. The difference was statistically significant （x2 = 23.7, P〈0.01）. The detection rate of rectal carcinoid was 0.2 （4/1 990）. Conclusions The prevalence of colorectal polyps and cancer is high in screening community people with high-risk of colorectal cancer. Colorectal cancer screening in community people ≥ 50 years old with sequential screening method is important.