重庆地区结直肠癌高危人群结直肠镜免费筛查的依从性及影响因素研究

Adherence of free colonoscopy screening and its influencing factors among high-risk populations of colorectal cancer in Chongqing

目的：分析重庆市结直肠癌高危人群筛查依从性及主要影响因素,为政府对重庆地区健康保健决策提供参考依据。方法：该研究基于重庆市＂城市癌症早诊早治项目＂,随机选取507例结直肠癌高危人群根据自身意愿决定是否参与结直肠镜免费筛查,并完成结直肠癌筛查问卷调查,分析直肠癌高危人群筛查依从性的主要影响因素。结果：507例研究对象中,18.6%接受了结直肠镜检查。多因素logistic回归分析发现：较大年龄（OR=0.967,95%CI=0.937~0.998）、结直肠癌家族史（OR=0.182,95%CI=0.087~0.380）、认为自己是结直肠癌发病高风险人群（OR=0.495,95%CI=0.366~0.668）是影响结直肠镜筛查依从性的保护因素;工作忙没时间（OR=8.879,95%CI=2.550~30.914）、害怕肠镜检查有痛苦（OR=21.140,95%CI=4.841~92.313）、害怕肠镜检查肠道准备太复杂（OR=22.849,95%CI=2.822~185.002）是影响结直肠镜筛查依从性的危险因素。结论：在今后的干预工作中,应针对结直肠癌高危人群进一步加大社区健康教育,使其意识到自己为高危人群,同时缓解该人群对结直肠镜筛查的恐惧心理,进而提高结直肠镜筛查依从性。

Objective：To analyze the demographic characteristics and the potential influencing factors of adherence of colonoscopy screening among high-risk populations of colorectal cancer（CRC）in Chongqing China. Methods：The study was based on the ＂early detection and treatment of cancer project＂in Chongqing. Totally 507 participants at high risk of CRC were selected to answer the colonoscopy screening questions. Multivariate stepwise logistic regression was used to determine which factors had a statistically significant effect on adherence of colonoscopyscreening. Results：Of the 507 participants,18.6% accepted the colonoscopy screening. Data from the multivariate logistic regression revealed that older people（OR=0.967,95%CI=0.937 to 0.998）who have family history of CRC（OR =0.182,95% CI =0.087 to 0.380） or consider himself at high risk of CRC（OR =0.495,95% CI =0.366 to 0.668） were more willing to accept the colonoscopy screening,while busy working（OR=8.879,95%CI=2.550 to 30.914）,fearing the pain of colonoscopy（OR=21.140,95%CI=4.841 to 92.313）and complicated bowel preparation（OR=22.849,95%CI=2.822 to 185.002）were independent barriers for colonoscopy screening. Conclusion：Effective intervention should be adopted to make people realize that they are at high risk of CRC. And at the same time health education program is needed to ease the fear of colonoscopy screening,thus improving colorectal colonoscopy screening adherence.