广州市从化街口街社区大肠癌筛查模式初探

The study of colorectal cancer screening methods in Jiekou street community

目的评价不同筛查方法对广州市从化街口街社区大肠癌筛查结果的影响。方法筛查对象为广州市从化街口街社区居民,随机分成两组,分别采用"问卷调查-大便潜血检查-电子结肠镜检查"(问卷+FOBT组)(n=2 052例)及"大便潜血检查-电子结肠镜检查"(FOBT组)(n=2 051例)筛查方法,比较两种筛查方法对大肠癌疾病的检出率。结果通过问卷调查及大便隐血检查筛出高危人群745例,阳性率18.16%;其中问卷+FOBT组筛出高危人群403例,FOBT组筛出高危人群342例;高危人群行电子结肠镜发现大肠息肉115例,大肠肠癌3例,大肠炎症18例,其他疾病4例。"问卷调查-大便潜血检查-电子结肠镜检查"方案大肠疾病检出率24.57%(99/403),相对"大便潜血检查-电子结肠镜检查"方法的检出率11.99%(41/342)高,差异有统计学意义(χ2=11.07,P=0.002)。结论使用"问卷调查-大便潜血检查-电子结肠镜检查"能有效提高大肠息肉和大肠癌的检出率,大肠癌早期筛查对于降低广州市从化街口街社区居民大肠疾病的发病率有重要意义。

Objective To investigate the outcomes of different methods in colorectal cancer screening in Jiekou street community. Method The residents in Jiekou street community were randomly divided into two groups（group1 ：questionnaire-fecal occult blood test-colonoscopies;group2 ：fecal occult blood test-colonoscopies）,and analysis of different screening methods for the detection rate of colorectal disease. Results Among all the subjects,745 were at high risk for colorectal cancer, accounted for 18.16% of the total subjects. Among the subjects who underwent the colonoscopy,115 had colorectal polyps and 3 subjects had cancer. Among the high-risk group who underwent colonoscopy,115 subjects were found to suffer from colorectal polyps,3 subjects colorectal cancer,18 sbujects colorectal inflammation,and 4subjects other diseases. The colorectal disease detection rate of using the method of questionnaire-fecal occult blood testcolonoscopies is 24.57%,which exceeds the detection rate of using the method of fecal occult blood test-colonoscopies by11.99%.The difference makes statistical sense（χ^2=11.07,P=0.002）. Conclusions The ＂questionnaire-fecal occult blood test-colonoscopies ＂method can improve colorectal polyps and colorectal cancer detection rate. It is important to establish the sequential colorectal cancer screening program for the early diagnosis of colorectal polyps and cancer in Jiekou street community.