北京城市居民癌症筛查接受度分析

Acceptability of cancer screening among urban residents in Beijing

目的对北京市开展的五类癌症(上消化道癌、大肠癌、肝癌、肺癌和乳腺癌)风险评估、临床筛查技术和筛查组织形式的接受度进行分析,为将来开展更大范围的癌症筛查和早诊早治项目的卫生决策提供科学依据。方法随机抽取2 724名参加北京城市癌症早诊早治项目的筛查个体进行筛查接受度问卷调查。结果 71.70%的风险评估受访者认为以问卷形式开展社区普通人群风险评估的初筛策略很好;临床筛查受访者对各项筛查技术的接受度差异有统计学意义(χ2=84.64,P<0.000 1),接受度最高和最低的分别为肺部低剂量螺旋薄层CT检查和上消化道腔镜检查,选择"完全可以接受"的比例分别为94.44%和46.93%;71.77%的受访者希望一次性就能将所有检查项目内做完,但也有11.16%的受访者希望将多项临床检查分在不同的日期进行。结论以问卷形式开展社区普通人群风险评估的初筛策略可行性较好,高危人群对不同临床筛查项目的接受度差异较大,临床筛查组织形式应有一定的灵活性。

Objective To analyze the acceptability of cancer screening, including risk assessment, clinical screening techniques and organizational forms in upper digestive tract, colon and rectum, liver, lung cancer, and breast cancer screening among urban residents in Beijing and to provide a scientific basis for health decision-making on carrying out large-scale cancer screening and early diagnosis and treatment. Methods A random sample of 2 724 residents participat- ing in early cancer detection and treatment project in Beijing was selected and surveyed with a questionnaire about accept- ability of the cancer screening. Results Totally 71.20% of the respondents considered that the risk assessment through a questionnaire for general community population as a preliminary screening strategy was very good. The acceptability of the screening techniques for the five cancers was different among the respondents receiving clinical screening（x2 =84. 64, P 〈0. 000 1 ）. The acceptability of low-dose spiral and thin-section computed tomography（CT） scan was the highest, and the acceptability of upper gastrointestinal endoscopy was the lowest, with the ratios of ＂perfectly acceptable＂ of 94. 44 % and 47.10%, respectively. There were 71.77% of the respondents hoping to finish all the examinations for the five cancers＇ screening once a time, but there were also 11. 16% of the respondents wanting to receive two different clinical screening examinations in separate date. Conclusion The cancer risk assessment with a questionnaire has a good feasi- bility among general community population but there are obvious differences in the acceptability for different clinical screening items among the population at higher risk, suggesting flexibility of cancer screening organization form needs to be improved.