结直肠癌患者一级亲属对结直肠癌筛查认知状况的调查分析

Investigation and analysis on cognition of first-degree relatives of patients with colorectal cancer on colorectal cancer screening

目的:调查结直肠癌(CRC)患者一级亲属(FDRs)对CRC筛查的认知现状,探讨CRC筛查中存在的问题。方法:采用目标抽样法选取2019年1—12月于本院结直肠外科进行CRC手术治疗且术后经病理诊断为CRC的患者的FDRs 49名(年龄40~75岁),对FDRs进行问卷调查并收集调查数据,分析FDRs对CRC筛查的认知现状。结果:CRC患者FDRs中40~50岁者21名,51~75岁者28名;男性27名,女性22名;CRC患者的子女31名,兄弟姐妹10名,父母8名。26.5%(13/49)FDRs知晓“FDRs的CRC发病风险增加”,22.4%(11/49)FDRs“过去5年内做过结肠镜检查”。75.5%(37/49)FDRs无“医务人员建议大于40岁行结肠镜检查”。年龄40~50岁、大专及大专以上学历和居住地为城市者“FDRs的CRC发病风险增加”知晓率和“过去5年内做过结肠镜检查”率高于51~75岁、大专以下学历和农村居住者(P<0.05)。过去5年内未做过结肠镜检查的38名CRC患者FDRs中,认为“无身体不适症状不需要进行结肠镜检查”、恐惧结肠镜检查过程和认为结肠镜检查繁琐费时等是影响FDRs进行结肠镜筛查的主要原因;经过沟通,22名FDRs(57.9%)改变了认知,愿意接受结肠镜筛查。结论:CRC患者FDRs对CRC筛查的认知严重不足。加大CRC筛查的健康宣教力度和医保政策的支持,是提高CRC筛查率的重要措施。

Objective:To investigate the cognitive status of first-degree relatives(FDRs)of the patients with colorectal cancer(CRC)on the CRC screening,and to reveal the problems in the CRC screening.Methods:Forty-nine FDRs aged 40-75 years from the CRC patients who underwent the colorectal cancer surgery in the Department of Colorectal Surgery of our hospital from January 2019 to December 2019 and were pathologically diagnosed as CRC after the surgery were selected by target sampling method.The questionnaire survey was conducted in the FDRs and the survey data were collected to analyze the cognitive status of the FDRs on CRC screening.Results:Among the FDRs of CRC patients,21 cases were 40-50 years old and 28 cases were 50-75 years old;27 males and 22 females;31 children,10 siblings,and 8 parents.Only 26.5%(13/49)of the FDRs were aware of the“increased risk of CRC in FDRs”and only 22.4%(11/49)of participants had“had a colonoscope in the past 5 years”.75.5%(37/49)of the FDRs did not have“medical staff recommended colonoscope over 40 years old”.The awareness rate of“increased risk of CRC for FDRs”and“had a colonoscope in the past 5 years”among the FDRs aged 40-50 years old,living in urban,college degree or above were higher than those aged 51-75 years old,with below college and rural residents.Among the 38 FDRs of CRC patients who had not undergone colonoscope in the past 5 years,the main reasons which affected the FDRs to do the colonoscopy screening were“no physical symptoms,no need to undergo colonoscope”,fear of colonoscope process,and the tedious and time-consuming colonoscope.Of the 38 FDRs of CRC patients,22(57.9%)cases changed their cognition and were willing to undergo colonoscopy after the communication.Conclusion:The cognition of CRC patients’FDRs on the CRC screening is seriously insufficient.It is an important measure to increase the CRC screening rate to strengthen the health education of CRC screening with the support of medical insurance policy.