2014-2017年厦门市翔安区结直肠癌伺机性筛查的结果分析

Analysis of opportunistic screening of colorectal cancer in Xiang'an District of Xiamen City from 2014 to 2017

目的分析厦门市翔安区结直肠癌早期诊断、筛查现状,探讨结直肠癌伺机筛查的必要性和可行性。方法选取40~74岁常住居民为研究对象,通过调查问卷和粪隐血试验(FOBT)进行初筛,对初筛后高危人群检测血清肿瘤标志物及行结肠镜检查、部分被检者行病理学检查。结果初筛共18000例,其中男10575例(58.75%)、女7425例(41.25%),共筛选高危人群3251例(18.06%),其中男性(20.86%)显著多于女性(14.07%),差异有统计学意义(P<0.05)。高危人群检出率在不同年龄段存在差异(P<0.05),其中>70岁检出率最高(25.96%)。在高危人群中,接受电子肠镜检查2793例,共检出结直肠癌49例(1.75%)、息肉630例(22.56%),其中腺瘤性息肉499例(17.87%)、非腺瘤性息肉131例(4.69%)。在结直肠癌检出人群中,男性(32例,1.15%)与女性(17例,0.61%)之间无显著差异(χ~2=0.827,P=0.363),在不同年龄段检出率有显著差异,其中以61~70岁为最高(29例,1.04%),进一步对该人群进行高危因素分布分析,显示FOBT阳性、有肠道腺瘤史、家族有癌症史位居前三位。结论对厦门市翔安区结直肠癌高危人群进行伺机筛查有利于结直肠癌的早期确诊,具有重要的实践意义。

Objective To analyze the early diagnosis and screening status of colorectal cancer in Xiang＇an District of Xiamen City and discuss the necessity and feasibility of opportunistic screening of colorectal cancer. Methods Residents of 40~74 years old were recruited for this study. Questionnaire and fecal occult blood test（FOBT） were performed for preliminary screening. Then the high-risk people were selected to undergo examinations to detect the serum tumor markers, and to receive colonoscopy and pathology. Results In this study, 18000 people were screened, including 10575 males（58.75%） and 7425 females（41.25%）. A total of 3251 cases of high risk subjects（18.06%） were screened, with significantly more males（20.86%） than females（14.07%）（P 〈0.05）. The detection rates of high-risk subjects were different across different ages（P 〈0.05）, and the highest detection rate was over 70 years old（25.96%）. Among the high risk subjects, 2793 received colonoscopies, of which 49（1.75%） were found to have colorectal cancer, and 630（22.56%）polyps, including 499 adenomas（17.87%） and 131 non-adenomatous polyps（4.69%）. In 49 cases of colorectal cancer, 32 were males（1.15%） and 17（0.61%） were female, with no significant difference（χ~2= 0.827, P = 0.363）. There was a significant difference in the detection rate of colorectal cancer among different age groups. The age group of 61-70 years old had the highest detection rate（29,1.04%）. Among the risk factors, FOBT positive, with a history of intestinal adenomas, and the family history of cancer were the most common ones. Conclusion The opportunistic screening of high risk of colorectal cancer is helpful for early diagnosis for colorectal cancer in Xiang＇an District of Xiamen City, which has very important clinical practice significance.