广州市2015年大肠癌筛查结果分析

Results of Colorectal Cancer Screening in Guangzhou,2015

[目的]对2015年广州市大肠癌筛查结果进行分析和总结,为项目策略调整提供依据和思路。[方法]收集、整理2015年广州市大肠癌筛查数据,计算和比较不同性别人群参与性、粪便隐血检测（FOBT）阳性率、初筛阳性率和肠镜顺应性,分析不同区域居民肠镜顺应性以及影响肠镜检查顺应性的因素。[结果]2015年广州市105 939人参与筛查,超过60%为女性。全市总体问卷阳性率为11.97%、两次FOBT阳性率分别为7.90%和6.63%、初筛阳性率为19.73%。男性、女性肠镜顺应性分别为18.50%和17.03%,男性高于女性（χ^2=7.557,P〈0.01）。肠镜免费区域肠镜顺应性为20.27%,明显高于其他肠镜不免费地区的10.70%（χ^2=205.511,P〈0.001）。多因素Logistic回归分析结果显示,初筛结果阳性后参加肠镜检查的影响因素,男性高于女性（OR=1.128,95%CI：1.024-1.242）,已婚人群高于未婚/离婚/丧偶人群（OR=1.331,95%CI：1.143-1.550）,肠镜免费区域高于不免费（OR=2.263,95%CI：2.015-2.254）,城区居民低于郊区居民（OR=0.803,95%CI：0.717-0.899）。[结论]大肠癌筛查过程中,应考虑性别差异,促进男性参与性;重点提高初筛阳性者的肠镜顺应性,尤其城区人口和女性;要充分考虑费用减免和家庭支持对肠镜检查顺应性的促进作用。

[Purpose] To analyze the results of colorectal cancer screening in Guangzhou city in2015,so as to provide implications for colorectal cancer screening policies and strategies. [Methods]Data of colorectal cancer screening in Guangzhou were collected. The participation,positive rate of fecal occult blood test（FOBT）,the positive screening rate and detection rate of colonoscopy were analyzed and compared between in different genders and different districts. Logistic regression analysis was performed to assess the impact factors. [Results] There were 105 939 residents participated in the screening and more than 60% of the participants were woman. The positive rate of questionnaire was 11.97%,the positive rate of the first FOBT and second FOBT was 7.90% and 6.63%,respectively. The positive screening rate was 19.73%. The detection rate of colonoscopy was 18.50% in man and 17.03% in woman（χ^2=7.557,P〈0.01）. The detection rate of colonoscopy in areas with free colonoscopy was 20.27%,and this rate was 10.70% in the with charged colonoscopy（P〈0.001）. Multivariate Logistic regression showed that compliance for colonoscopy examination in male was higher than that in female（OR=1.128,95%CI：1.024-1.242,P〈0.05）,the compliance in married people was higher than that in unmarried/divorce /widowhood people（OR =1.331,95% CI：1.143 -1.550,P 〈0.001）,in free colonoscopy area was higher than that charged colonoscopy area（OR=2.263,95%CI：2.015-2.254,P〈0.001）. [Conclusion] Measures should be taken to promote more man to participate in the screening,to encourage more panticipants to receive colonoscopy examination,especially for the urban residents and woman. The promotion of free charge and family support should be attached enough importance.