2018-2019年河北省城市癌症早诊早治项目肺癌筛查分析

Analysis of lung cancer screening of urban residents in Hebei province,2018-2019

目的肺癌是严重威胁我省居民生命健康的疾病之一。低剂量螺旋CT筛查是肺癌防控的重要手段之一。本研究分析2018-2019年河北省城市居民肺癌高危风险评估以及低剂量螺旋CT筛查结果,为河北省肺癌防治提供基础数据。方法2018-11-01-2019-05-15采取整群抽样的方法,以定点筛查医院为基础,选择合适的有关社区、街道作为筛查点。肺癌筛查对象为40~74岁的本地常住居民。调查对象自愿参加城市癌症早诊早治项目,完整填写《城市癌症早诊早治项目防癌风险评估问卷》,对评估出为肺癌高危的人群进行低剂量螺旋CT筛查,并对筛查的检出率等指标进行分析。结果2018-2019年,共有37849名40~74岁居民进行了危险因素调查和高危人群风险评估,肺癌高危人数为11052名,高危率为29.20%。肺癌筛查共计6223例,60~64岁筛查人数最多。发现阳性结节883例,阳性率为14.19%,可疑肺癌103例,阳性率为1.66%。年龄别阳性结节检出率和可疑肺癌检出率均在70~74岁达到高峰。筛查确诊肺癌患者38例,确诊肺癌检出率为0.61%,其中男性肺癌检出率为0.79%,女性为0.47%。确诊肺癌患者中,Tis期以及Ⅰ期患者约占全部确诊且有病理分期病例的77.78%,远高于医院住院肺癌患者Ⅰ期所占比例(26.56%)。同时,共发现其他病变共计6547例。结论通过早诊早治筛选高危人群,并结合低剂量螺旋CT进行筛查,可有效提高阳性结果的检出率,为肺癌的防控体系提供理论依据。

OBJECTIVE Lung cancer is one of the most seriously disease in Hebei Province.Low-dose spiral CT screening is the effective method of lung cancer prevention and control.This study aimed to analyze the results of lung cancer screening in Hebei Province in 2018-2019 and to evaluate the effect of early diagnosis and treatment on lung cancer prevention.METHODS From November 1,2018 to May 15,2019,a cluster sampling method was adopted based on designated screening hospitals,and appropriate communities and streets were selected as screening points.The subjects of lung cancer screening were local residents aged 40 to 74.Respondents voluntarily participated in the Urban Cancer Early Diagnosis and Treatment Project,and completed the"Urban Cancer Early Diagnosis and Early Treatment Project AntiCancer Risk Assessment Questionnaire".People who were assessed to be at high risk of lung cancer received low-dose spiral CT screening.RESULTS From 2018 to 2019,a total of 37849 residents aged 40-74 years old underwent risk factor surveys and risk assessments for high-risk groups.The number of high-risk lung cancer patients was 11052,and the highrisk rate was 29.20%.A total of 6223 subjects did the low dose spiral CT and people aged 60-64 was the most active population in lung cancer screening.A total of 883 cases were diagnosed as positive nodules and the positive rate was14.19%.103 cases were diagnosed as suspicious lung cancer and the positive rate was 1.66%.The age-specific positive rate of positive nodules and suspicious lung cancer increased with age and peaked at aged 70-74.A total of 38 cases were diagnosed as lung cancer with lung cancer detection rate of 0.61%.Detection rate in male was 0.79%and in female was0.47%.A total of 77.78%patients were in Tis stage and stageⅠin lung cancer screening,while it was only 26.56%in lung cancer inpatients.At the same time,a total of 6547 other lesions were found.CONCLUSION Screening high-risk groups through early diagnosis and treatment,combined with low-dose spiral CT for screening,can effectively increase the detection rate of positive results and provide a theoretical basis for the prevention and control system of lung cancer.