上海市闵行区筛查人群结直肠癌发病风险及确诊患者生存率分析

Analysis on the risk of colorectal cancer in the screening population and the survival rate of confirmed patients in Minhang District,Shanghai

目的分析人群经过结直肠癌筛查后的发病趋势及生存率,评价结直肠癌筛查项目的中远期效果。方法基于上海市闵行区七宝镇结直肠癌试点筛查项目,通过上海市恶性肿瘤登记系统及上海市生命统计系统追踪筛查人群结直肠癌的发病情况及确诊患者的生存情况,分析不同随访周期内相对于当地一般人群的标准化发病比(standardized incidence ratio,SIR)及确诊患者的生存率。结果在所有参与筛查人群中共发现结直肠癌确诊患者144例,发病率为71.78/10万人年,SIR为0.71(95%CI:0.59~0.82)。随访时间小于1年、1~3年、4~6年以及7年以上的SIR分别为1.83(95%CI:1.20~2.46)、0.75(95%CI:0.53~0.98)、0.77(95%CI:0.56~0.98)和0.45(95%CI:0.23~0.66)。在筛查阴性人群中共发现结直肠癌确诊患者89例,发病率为51.4/10万人年,SIR为0.51(95%CI:0.40~0.62)。144例确诊患者3年生存率为77.2%,5年生存率为69.9%。结论参与筛查人群中结直肠癌发病风险相较于当地同期一般人群有所降低。筛查降低了结直肠癌的发病风险,使确诊患者具有较高的生存率。

Objective To analyze incidence trend and survival rate of colorectal cancer in the population after screening,and to evaluate the mid-and long-term effects of colorectal cancer screening project.Methods The colorectal cancer pilot screening project was conducted in Qibao Town,Minhang District,Shanghai.The incidence of colorectal cancer and the survival of confirmed patients in the screening population were tracked through the Shanghai Malignant Tumor Registration System and the Shanghai Life Statistics System.The standardized incidence ratio(SIR)relative to the local general population and the survival rate of confirmed patients during different follow-up periods were analyzed.Results Overall crude incidence of colorectal cancer after screening was 71.78 per 105 person-years,and the SIR was 0.71(95%CI:0.59-0.82).When the follow-up time was less than 1 year,1-3 years,4-6 years,and more than 7 years,the SIR was 1.83(95%CI:1.20-2.46),0.75(95%CI:0.53-0.98),0.77(95%CI:0.56-0.98)and 0.45(95%CI:0.26-0.6).After screening,144 patients were confirmed.The 3-and 5-year survival rates were 77.2%and 69.9%.Conclusion After screening,the risk of colorectal cancer in the population is lower than that of the local general population in the same period.Screening reduces the risk of colorectal cancer,and confirmed patients had high survival rate.