2009-2018年辉县市上消化道肿瘤早诊早治项目筛查结果报告

Screening results of the programme for early diagnosis and treatment of upper gastrointestinal cancers in Huixian,2009-2018

目的肿瘤发病是一个漫长的过程,积极开展癌症防控及宣教工作,参与癌症早诊早治项目并制定切实可行的随访方案,可达到降低癌症发病率和死亡率的目的。本研究总结分析2009-2018年河南省辉县市上消化道癌早诊早治项目内镜筛查结果。方法采取整群抽样法,选择2009-2018年辉县市40~69岁村民作为筛查对象,采取内镜下碘染色检查及指示性活检,并经病理学诊断确诊,统计分析上消化道癌筛查结果。结果2009-2018年共完成内镜筛查19243人次,共检出重度异型增生、高级别上皮内瘤变及癌412例,检出率为2.14%。其中食管癌检出率为1.35%(259例),贲门癌检出率为0.56%(108例),胃癌检出率为0.23%(45例)。早期病例368例,早诊率为89.32%,治疗病例327例,治疗率为79.37%。随访1604例,发现新病例40例,检出率为2.5%,均为早期病例,随访治疗率为100%。结论河南省辉县市上消化道癌以食管癌为主。在上消化道癌高发区开展上消化道癌早诊早治项目,内镜检查+碘染色检查+指示性活检,可有效发现可干预的癌前病变和早期癌,同时加强对高危人群的随访,对发现的早期病变进行有效干预和治疗,可以提高上消化道癌的检出率及治疗率,从而达到早期发现、早期治疗的目的。

OBJECTIVE Cancer is a long process.Actively developing cancer prevention and control and propaganda work,participating in the early diagnosis and treatment of cancer and developing a feasible follow-up plan can reduce the incidence rate and mortality rate of cancer.This study is to summarize and analyze the results of endoscopic screening for upper gastrointestinal cancer in Huixian,Henan Province from 2009 to 2018.METHODS A cluster sampling method was used to screen 40-69 year-old villagers in Huixian from 2009 to 2018,and the results of upper digestive tract cancer screening were analyzed.RESULTS From 2009 to 2018,19243 patients were screened by endoscopy,and 412 cases of severe dysplasia,high grade intraepithelial neoplasia and carcinoma were detected,the detection rate was 2.14%,among which 1.35%(259 cases)of esophageal carcinoma and 0.56%(108 cases)of gastric cardia carcinoma were detected.The detectable rate of gastric cancer was 0.23%(45 cases).368 cases of early disease,early diagnosis rate was 89.32%,treatment 327 cases,treatment rate was 79.37%.During the follow-up of 1604 cases,40 new cases were found,the detection rate was 2.5%,all were early cases,and the follow-up treatment rate was 100%.CONCLUSIONS Esophageal cancer is the main type of upper gastrointestinal cancer in Huixian City,Henan Province.Early diagnosis and treatment of upper gastrointestinal cancer can be effectively detected by endoscopic examination+iodine staining+indicative biopsy in high incidence area of upper gastrointestinal cancer.At the same time,strengthening the follow-up of high-risk groups,effective intervention and treatment of early lesions can improve the detection rate and treatment rate of upper gastrointestinal cancer,so as to achieve the purpose of early detection and early treatment.