检后随访在粪便隐血阳性人群中筛查结直肠癌的体会与教训

Experiences and lessons on follow-up after physical examination in fecal immunochemical test(FIT)-positive participants under colorectal cancer screening

目的探讨在健康体检人群中应用粪便隐血免疫化学检测法(FIT)筛查结直肠癌(CRC)的有效路径。方法回顾性分析太湖疗养院2012~2016年应用FIT检测的健康体检人群159 614例,应用排除和复查标准,复测FIT,两次阳性病例推荐内窥镜检查,恶性肿瘤疑似病例推荐专科就诊。结果 FIT阳性人群10 931例病理诊断恶性肿瘤16例(CRC 13例、胃癌3例)。CRC在FIT检测人群中的不完全检出率8.15/10万,在FIT阳性人群中的不完全检出率118.93/10万。结论检后随访FIT结果、内窥镜检是体检中心筛查CRC的有效路径,其中提高内窥镜检依从性是关键。

Objective This study explored an effective pathway on the application of fecal immunochemical test（FIT） in healthy population under colorectal cancer screening. Methods 159 614 cases that underwent FITtest from 2012 to 2016 in our hospital were retrospectively analyzed. 10 931 cases were FIT positive. The steps for the follow-up is as below：（1）The exclusion and review criterions were performed;（2）FITtest was re-tested;（3）Positive participants in both tests were recommended to undergo Endoscopy;（4）Cases with suspected malignant tumors were suggested to see a specialist. Results 16 cancer cases（including 13 colorectal cancer（CRC） patients and 3 gastric cancer patients） were confirmed by pathologic diagnosis. The detection rate of CRC according to incomplete survey in participants underwent FIT test were 8.15/100 000（0.08‰）. The detection rate of CRC according to incomplete survey in positive participants in both FIT tests were 118.93/100 000（1.19‰）. Conclusion Follow-up of FIT test and endoscopy after physical examination is the effective pathway in CRC screening,in which compliance of endoscopy plays an important role.