2013-2019年河南省城市癌症早诊早治项目地区人群结肠镜筛查结果和依从性分析

Analysis of detection rate and compliance of colorectal cancer screening with colonoscopy in urban areas of Henan Province,2013-2019

目的评价2013-2019年河南省城市癌症早诊早治项目地区人群结肠镜筛查结果和依从性。方法研究对象来源于河南省"城市癌症早诊早治项目",于2013年10月至2019年10月,以郑州市、驻马店市、安阳市、洛阳市、南阳市、焦作市、濮阳市和新乡市为研究地区,招募282 377名40~74岁在本地居住3年以上的人群为研究对象。采用患癌风险评估问卷收集基本人口学特征、饮食习惯、生活环境和习惯、心理和情绪、疾病既往史和癌症家族史以及女性的生理和生育史等信息,采用癌症高危风险评估系统评价研究对象的结直肠癌的患病风险;同时从项目参与医院获取参与研究对象的结肠镜筛查参与情况和筛查结果。采用χ^(2)检验分析不同特征人群筛查结果及筛查依从性的差异。结果 282 377名对象年龄为(55.26±8.68)岁,男性占44.80%(126 505名),教育程度以初中/高中/大专为主67.63%(190 694名)。共有39 834名(14.11%)对象被评估为结直肠癌高危人群,其中仅有7 454名(18.71%)研究对象接受结肠镜筛查,50~54岁(20.42%)和55~59岁(20.43%)年龄段参与率较高,70岁及以上年龄段最低(12.30%)(P<0.001)。接受结肠镜筛查的研究对象中共检出17例结直肠癌,检出率为0.23%(17/7 454)。结论结肠镜作为结直肠癌筛查的手段有助于早期发现结直肠病变,但结肠镜筛查依从性较差。

Objective To evaluate the compliance of colonoscopy screening and the detection rate of colorectal lesions with colonoscopy in urban areas of Henan province from 2013 to 2019.Methods The study objects were derived from the Cancer Screening Program in Urban Henan Province,China.From October 2013 to October 2019,282377 residents,who had lived in the local area for more than three years,were recruited from Zhengzhou,Zhumadian,Anyang,Luoyang,Nanyang,Jiaozuo,Puyang and Xinxiang.The cancer risk assessment questionnaire was used to collect basic demographic characteristics,eating habits,living environment and habits,psychology and emotions,past disease history and family history of cancer,and women′s physiological and reproductive history.The cancer risk assessment model was used for evaluating the risk of colorectal cancer.The data related to colonoscopy screening was obtained from the participating hospitals.Chi-square test was used to analyze the compliance rate among different groups.Results The 282377 subjects were(55.26±8.68)years old,of which 44.80%(126505)were males,and 67.63%(190694)had junior/senior/tertiary education background.A total of 39834(14.11%)subjects were assessed to be at high risk for colorectal cancer,of which 7454 took the following colonoscopy screening,yielding a participation rate of 18.71%.The screening rate was higher in those aged 50 to 54(20.42%)and 55 to 59(20.43%)years,and lowest in those aged 70 years and older(12.30%)(P<0.001).A total of 17 colorectal cancer cases were detected,with a detection rate of 0.23%(17/7454).Conclusion Colonoscopy as a means of screening for colorectal cancer is helpful for early detection of colorectal lesions,but the participation rate is poor.