内蒙古锡林郭勒盟居民结直肠癌风险筛查分析

Screening analysis of colorectal cancer in Xilingol League of Inner Mongolia

目的 调查内蒙古锡林郭勒盟结直肠癌发生的高危人群,筛查结直肠癌患者,为当地结直肠癌的防治提供参考依据。方法 于2019年1月至2021年12月对内蒙古锡林郭勒盟居民进行结直肠癌风险筛查,首先进行调查问卷的初筛,然后建议高危人群进行序贯结肠镜检查,分析不同特征居民的结直肠癌发生状况。结果 本研究共发放调查问卷5283份,回收5020份有效问卷,问卷有效率为95.0%,其中结直肠癌高危人群950例,占18.9%,癌症家族史、个人癌症或结直肠息肉史、粪便隐血试验阳性、排便异常、高危个人史这5项高危因素人群分别有136例、208例、268例、302例、409例。男性人群的癌症家族史、高危个人史等高危因素以及初筛为高危人群的占比均显著高于女性人群(均P<0.05),年龄65~80岁人群粪便隐血试验阳性、排便异常、高危个人史等高危因素以及初筛为高危人群的占比均显著高于40~64岁者(均P<0.05),蒙古族与汉族的高危个人史的占比均显著高于其他民族(均P<0.05)。950例初筛为结直肠癌高危人群中,共有905例(95.3%)完成结肠镜检查,共检出38例结直肠癌,占4.2%,包括21例直肠癌和17例结肠癌;其余4070例初筛为结直肠癌低危人群中,共有1283例(31.5%)行结肠镜检查,共检出15例结直肠癌,占1.2%,包括8例直肠癌与7例结肠癌。年龄65~80岁、有癌症家族史、粪便隐血试验阳性、排便异常、高危个人史、结肠癌风险初筛为高危的人群结直肠癌检出率分别显著高于年龄40~64岁、无癌症家族史、粪便隐血试验阴性、排便正常、无高危个人史、初筛为低危者(均P<0.05)。结论 内蒙古锡林郭勒盟居民开展结直肠癌风险问卷初筛和结肠镜的序贯检查对结直肠癌的早期发现具有重要意义。

Objective To investigate the high-risk population of colorectal cancer in Xilingol League of Inner Mongolia,screen colorectal cancer patients,then to provide reference for the prevention and treatment of colorectal cancer in local area.Method FromJanuary 2019 to December 2021,the residents of Xilingol League of Inner Mongolia were screened for colorectal cancer risk.The questionnaire was firstly screened,and then the sequential colonoscopy was recommended for high-risk groups to analyze the incidence of colorectal cancer in residents with different characteristics.Result A total of 5283 questionnaires were distributed in this study,and 5020 valid questionnaires were recovered.The effective rate of the questionnaire was 95.0%,of which 950 cases were high-risk groups for colorectal cancer,accounting for 18.9%,including 136 cases,208 cases,268 cases,302 cases and 409 cases of family history of cancer,personal history of cancer or colorectal polyps,positive fecal occult blood test,abnormal defecation,and high-risk personal history.The proportions of high-risk factors such as family history of cancer,high-risk personal history and primary screening of high-risk in men were significantly higher than that in women (all P<0.05).The proportions of high-risk factors such as positive fecal occult blood test,abnormal defecation,high-risk personal history and primary screening of high-risk in people aged 65 to 80 years old were significantly higher than that in people aged 40 to 64 years old (all P<0.05),and the proportions of high-risk personal history of Mongols and Han nationality were significantly higher than that of other nationalities (all P<0.05).A total of 905 cases (95.3%) of the 950 cases high-risk colorectal cancer completed colonoscopy,and a total of 38 cases of colorectal cancer were detected,accounting for 4.2%,including 21 cases of rectal cancer and 17 cases of colon cancer.Among the other 4070 low-risk groups screened for colorectal cancer,a total of 1283 cases (31.5%) underwent colonoscopy,and a total of 15 cases of colorectal cancer were detected,accounting for 1.2%,including 8 cases of rectal cancer and 7 cases of colon cancer.The detection rate of colorectal cancer in people aged 65 to 80 years old,with a family history of cancer,positive fecal occult blood test,abnormal defecation,high-risk personal history,and primary screening of high-risk was significantly higher than those in people aged 40 to 64 years old,without a family history of cancer,negative stool occult blood test,normal defecation,no high-risk personal history,and primary screening of low-risk (all P<0.05).Conclusion It is of great significance for the early detection of colorectal cancer to carry out the initial screening of questionnaires and the sequential examination of colonoscopy among the Xilingol League residents of Inner Mongolia.