马鞍山市社区肺癌高危人群低剂量螺旋CT免费筛查依从性影响因素分析

Analysis of influencing factors on compliance of free low-dose computed tomography screening among high-risk population of lung cancer in the community of Ma'anshan City

目的 分析马鞍山市社区肺癌高危人群参与低剂量螺旋CT (low-dose computed tomography,LDCT)免费筛查的依从性及相关影响因素,探讨提高筛查水平的方法。方法 通过肺癌风险评估问卷共收集10 038名社区居民的基线资料,包括行为习惯、人口学特征、个人疾病史和家族史等内容,参照《中国肺癌低剂量螺旋CT筛查指南》共筛选出高危人群3 376人作为研究对象,使用χ^(2)检验和logistic回归分析影响免费LDCT筛查依从性的因素。结果高危人群中共有2 289人参与LDCT检查,参与率为67.80%,男性1 581人,占69.07%,女性708人,占30.93%。多因素logistic回归显示,女性(OR=1.373,95%CI:1.029~1.833)、年龄60~69岁(OR=1.724,95%CI:1.436~2.071)、≥70岁(OR=1.489,95%CI:1.190~1.864)、每周锻炼5次及以上(OR=1.337,95%CI:1.138~1.572)、有肺结核家族史(OR=1.598,95%CI:1.013~2.521)、有哮喘家族史(OR=1.695,95%CI:1.315~2.532)、有糖尿病史(OR=1.297,95%CI:1.052~1.599)、有肿瘤家族史(OR=1.692,95%CI:1.443~1.983)筛查的依从性更高;大专及以上人群(OR=0.519,95%CI:0.377~0.714)依从性更低。结论 马鞍山市肺癌高危人群LDCT筛查的依从性不高,根据影响筛查依从性的因素,针对不同的人群采取相应措施提高筛查依从性。

Objective To analyze the compliance and related influencing factors of low-dose computed tomography(LDCT)free screening among high-risk lung cancer population in Ma'anshan City,and to explore the methods to improve the screen-ing level.Methods A total of 10038 community residents'baseline data were collected through the lung cancer risk as-sessment questionnaire,including behavioral habits,demographic characteristics,personal disease history and family history,and so on.A total of 3376 high-risk people were selected as the subjects of this study according to China National Lung Cancer Screening Guideline with Low-dose Computed Tomography.Factors influencing compliance of free LDCT screening were analyzed usingχ^(2) test and logistic regression.Results A total of 2289 people in high-risk groups participated in LDCT examination,with a participation rate of 67.80%,including 1581 males(69.07%)and 708 females(30.93%).Multivariate logistic regression showed that females(OR=1.373,95%CI:1.029-1.833),60-69 years old(OR=1.724,95%CI:1.436-2.071),≥70 years old(OR=1.489,95%CI:1.190-1.864),exercising 5 times or more per week(OR=1.337,95%CI:1.138-1.572),family history of tuberculosis(OR=1.598,95%CI:1.013-2.521),family history of asthma(OR=1.695,95%CI:1.315-2.532),history of diabetes(OR=1.297,95%CI:1.052-1.599),and family history of tumor(OR=1.692,95%CI:1.443-1.983)had higher screening compliance.Adherence was lower among those with college and above(OR=0.519,95%CI:0.377-0.714).Conclusion The compliance of LDCT screening for lung cancer high-risk pop-ulation in Ma'anshan City is not high.According to the influencing factors,appropriate measures should be taken to improve screening compliance for different populations.