广州市越秀区大肠癌筛查方法评价

Evaluation of colorectal cancer screening methods in Yuexiu district in Guangzhou

目的为了更好地开展居民大肠癌筛查,分析比较危险因素筛查问卷和大便潜血检查(FOBT)两种方法的检出率,以及与病理诊断相比的灵敏度和特异度。方法对2014年对广东省广州市越秀区的1 501名居民进行了大肠癌筛查结果进行分析。采用了危险因素筛查问卷和FOBT检测两种方法。结果有1 335名居民接受调查问卷筛查方法,共筛查出825位易患大肠癌的危险人群,检出率为61.8%。有704位居民接受FOBT方法,共检出67位为阳性,检出率9.5%。有1 153名居民接受肠镜检查和病理检查,筛查出636名居民有病变,阳性率为55.2%。筛查问卷方式检验大肠癌的灵敏度为65.5%,特异度为10.3%,ROC曲线下面积为0.58;FOBT检验方法灵敏度为11.1%,特异度为84.8%,ROC曲线下面积为0.61。结论此次筛查问卷和FOBT方法效果均不够理想,建议问卷法+FOBT检测筛查兼顾灵敏度和特异度。

Objective To compare the detection rates, sensitivity and specificity of colorectal cancer screening by the risk factor screening questionnaire and the fecal occult-blood test（FOBT）. Method The results of the colorectal cancer screening for the 1 501 residents in Yuexiu District in Guangzhou, Guangdong Province in 2014 were analyzed. The risk factor screening questionnaire and the FOBT were adopted. Results 1 335 residents participated in the questionnaire,and 825 of them were detected as those with the risk of colorectal cancer, with a detection rate of 61.8%. The FOBT was adopted for 704 of the residents, and 67 of them were tested as positive, with a detection rate of 9.5%. 1 153 residents took the enteroscheocele and the pathological examination, and 636 of them encountered the pathological change, with a positive rate of 55.2%. The sensitivity, specificity and ROC curve area of the questionnaire screening for the detection of colorectal cancer were 65.5%, 10.3% and 0.58 respectively, while the sensitivity, specificity and ROC curve area of the FOBT were 11.1%, 84.8% and 0.61 respectively. Conclusion The effects of the two methods were not satisfactory,so it is suggested that resident compliance should be enhanced through the optimization of scheme design and screening procedure.