湖南省2017—2018年肺癌低剂量螺旋CT筛查结果和依从性分析

Screening results and compliance analysis of low-dose spiral CT for lung cancer in Hunan from 2017 to 2018

目的分析湖南省2017—2018年度城市癌症早诊早治项目中肺癌低剂量螺旋CT(Low-dose spiral CT,LDCT)筛查初步结果和依从性影响因素,为开展肺癌防控工作提供依据。方法在长沙市五个城区,动员所有40~74岁常住居民填写高危风险评估问卷,评估的肺癌高危者接受肺癌LDCT临床筛查,分析肺癌高危评估和LDCT筛查结果,用logistic回归分析LDCT筛查依从性的影响因素。结果两年中共有74768人参与高危人群评估,12789人被评估为肺癌高风险人群,高危率为17.1%;其中,6406人接受LDCT筛查,依从率为50.1%。LDCT筛查共发现疑似肺癌64人(1.0%),发现阳性肺结节268人(4.2%),且疑似肺癌和阳性肺结节的检出率随着年龄的增加而升高。对参加LDCT筛查的研究对象进行多因素分析,发现年龄、文化程度、职业、职业接触史、蔬菜摄入、室内油烟、经常体育锻炼、近年精神压抑、慢性呼吸系统疾病史和肺癌家族史共10个变量与LDCT筛查依从性有显著关联(P<0.05)。结论本研究发现了LDCT筛查依从性的影响因素,为未来有针对性地提高LDCT筛查依从性、提高肺癌筛查和早诊早治项目有效性提供理论依据。

Objective The objective of this study was to analyze the preliminary results of low-dose spiral CT(LDCT)screening for lung cancer and the influencing factors of the compliance in the Cancer Screening Program in Urban China in Hunan province from 2017 to 2018,so as to provide information for the prevention and control of lung cancer.Methods In five districts of Changsha city,all permanent residents aged 40~74 years were invited to fill in the high risk assessment questionnaire.The detected high-risk lung cancer patients received LDCT clinical screening for lung cancer.The results of high-risk lung cancer assessment and LDCT screening were analyzed,and logistic regression was used to analyze the influencing factors for the compliance rate of LDCT screening.Results A total of 74,768 people participated in the evaluation of high-risk groups in two years,and 12,789 people were evaluated as high-risk groups of lung cancer,with a high-risk rate of 17.1%;among them,6,406 people LDCT screening,with a compliance rate of 50.1%.A total of 64 participants(1.0%)suspected lung cancer were found in LDCT screening,and 268 patients(4.2%)were found to be positive pulmonary nodules.The detection rates of suspected lung cancer and positive pulmonary nodules increased significantly with the increase of age.Multivariate analysis was conducted on the research subjects participating in LDCT screening,and it was found that ten variables of age,education level,occupation,occupational exposure history,vegetable intake,indoor oil fume,regular physical exercise,recent mental depression,history of chronic respiratory diseases and family history of lung cancer were significantly associated with the LDCT screening compliance(P<0.05).Conclusion This study found the influencing factors of LDCT screening compliance,and provided a theoretical basis for the improvement of LDCT screening compliance,and improved the effectiveness of lung cancer screening and early diagnosis and treatment programs in the future.