徐州地区乳腺癌高危风险评估及筛查结果分析

High risk assessment of breast cancer and analysis of clinical screening results in Xuzhou area

目的分析徐州地区女性乳腺癌高危风险人群的流行病学特征,为徐州地区乳腺癌防控提供理论依据。方法采取整群随机抽样的方法,选取2013年-2016年徐州市区28个社区39 386人进行乳腺癌高危风险问卷调查及风险评估,评估为乳腺癌高危风险者将免费接受乳腺超声/X线检查,阳性者做病理诊断。结果在乳腺癌高风险人群中,最终确诊为乳腺癌的患者共19人,乳腺癌检出率为0.48‰(19/39 386)。多因素分析结果显示:经常吸烟(OR=3.80,95%CI:1.26~11.50)、经常饮酒(OR=3.70,95%CI:1.14~12.04)、有良性乳腺疾病史(OR=11.79,95%CI:3.34~41.70)是乳腺癌检出的独立危险因素;月经周期规律(OR=0.24,95%CI:0.09~0.64),有哺乳史(OR=0.23,95%CI:0.07~0.82)是乳腺癌检出的保护因素。结论经常吸烟、经常饮酒和有良性乳腺疾病史是影响徐州地区女性高危人群乳腺癌检出率的危险因素,在筛查过程中需要重点关注此类特征的人群。

Objective To investigate and analyze the breast cancer epidemiological characteristics of high risk women in Xuzhou area,so as to provide the theoretical basis for prevention and treatment of breast cancer.Methods Totally 39 386 women were randomly selected by the cluster sampling method in 28 communities in Xuzhou area from 2013 to 2016,and they were investigated by questionnaires for high risks of breast cancer and the risk assessments were performed.The women with high risks of breast cancer received the breast ultrasound/X-ray examinations and the positives were given pathological examinations.Results Among the high risk population,19 women were diagnosed as breast cancer(0.48‰,19/39386).the multivariate analysis showed that the independent risk factors for breast cancer were long-term smoking(OR=3.80,95%CI=1.26-11.50),long-term drinking(OR=3.70,95%CI=1.14-12.04),and breast benign diseases(OR=11.79,95%CI=3.34-41.70).The protective factors for breast cancer were regular menstrual periods(OR=0.24,95%CI=0.09-0.64) and breast-feeding history(OR=0.23,95%CI=0.07-0.82).Conclusion The long-term smoking,long-term drinking,and breast benign diseases are risk factors of breast cancer among the high risk population in Xuzhou area.Therefore,the women with these characteristics should be given special attention to in the process of breast screening.