2013-2015年上海市浦东新区居民大肠癌筛查情况分析

Analysis on the conditions of colorectal cancer screening among residents in Pudong New Area of Shanghai,2013-2015

目的 2013年以来开展的上海市重大公共卫生项目"社区居民大肠癌筛查"已惠及区域内数百万居民,本研究对2013-2015年浦东新区居民大肠癌筛查情况进行初步分析,为优化大肠癌筛查策略提供参考。方法以2013-2015年上海市浦东新区参加大肠癌筛查项目的居民为研究对象,分析社区初筛和肠镜参与情况,并对不同性别的居民基本信息及其肠镜确诊结果的分布进行比较。结果 2013-2015年浦东新区大肠癌完成社区初筛427 450人(2013年完成222 688人,占52.10%,2014年完成94 936人,占22.21%,2015年完成109 826人,占25.69%),其中男性173 644人,占40.62%,女性253 806人,占59.38%;<50岁8 069人,占1.89%,50~74岁368 974人,占86.32%;≥75岁50 407人,占11.79%;危险度评估阳性43 347人,粪便潜血检测试纸(fecal occult blood teats,FOBT)检测阳性56 294人,初筛阳性(危险度评估或单次FOBT阳性)总计91 392人,初筛阳性率为21.38%;参加全结肠镜检查20 084人,肠镜检查率为21.98%;检出大肠癌360例,早癌发现率为73.91%(170/230);癌前期病变2 096例,筛查早期发现率为97.16%(2 260/2 326)。结论浦东新区社区居民大肠癌筛查效果显著,尚需针对性别差异、风险评估及经济承受能力等方面采取一定措施优化筛查策略,从而提高筛查效益。

OBJECTIVE Colorectal cancer screening for community residents,which was the Shanghai major public health program,has benefited millions of people since 2013.This study aims to analyze the conditions of colorectal cancer screening among residents in Pudong New Area of Shanghai for providing a reference for the screening.METHODS The residents in the colorectal cancer screening of Pudong New Area in Shanghai were recruited in this analysis from 2013 to 2015.The conditions of community screening and early colonoscopy were analyzed,and the distribution of different groups in gender were compared in basic information of residents and diagnosis.RESULTS A total of 427 450 people have completed community colorectal cancer screening in Pudong new area from 2013 to 2015,52.10% （222 688）in 2013,22.21% （94 936）in 2014,and 25.69% （109 826）in 2015,including 173 644 men and 253 806 women,which were accounted for 40.62% and 59.38% ;and 8 069 were under the age of 50,368 974 were from 50 to 74 years old,and 50 407 were age of 75 and above,which were accounted for 1.89% ,86.32% and 11.79% ,respectively.The positive of risk assessment were 43 347,the positive of Fecal Occult Blood test were 56 294 people,and the positive（risk assessment or single positive FOBT）of screening were 91 392.The positive rate in community colorectal cancer screening was 21.38% ,and the positive rate in colonoscopy check was 21.98% （20 084 people participated in the colonoscopy）.About 360 patients with colorectal cancer were screened out,and the early carcinoma discovery rate was 73.91% （170/230）.The Pre-cancerous lesions were 2 096 cases,and the early detection rate was 97.16% in screening（2 260/2 326）.CONCLUSION It is remarkable for the colorectal cancer screening in community residents of Pudong new area,and there remains something to be done for the gender difference,risk assessment,and economic bear ability to take some measures to optimize screening strategy,so as to improve the efficiency of the screening.