结直肠癌高危人群参与结肠镜筛查的现状及影响因素分析

Current status and influencing factors analysis of colonoscopy screening participation in high-risk population with colorectal cancer

目的探讨结直肠癌高危人群结肠镜筛查的参与现状及其影响因素,为促进直肠癌高危人群的主动健康管理行为提供思路。方法选取杭州市临平区50~70岁结直肠癌高危人群624例作为研究对象,调查高危人群的一般资料、结肠镜筛查参与情况,采用二元Logistic回归分析结直肠癌高危人群参与结肠镜筛查的影响因素。结果624例结直肠癌高危人群,148例参与结肠镜检查,结肠镜检查参与率为23.72%;多因素分析结果显示,年龄、吸烟、喝酒、家庭月收入、息肉个人史、结肠癌家族史、大便习惯或性状改变、医疗保险、知晓结直肠癌相关症状、健康教育形式均为结直肠癌高危人群参与结肠镜筛查的独立影响因素(均P<0.05)。构建结直肠癌高危人群参与结肠镜筛查的风险预测模型,模型拟合度检验结果显示,χ^(2)=4.095,P=0.848;预测模型的AUC为0.892(P<0.05)。结论临床可基于年龄、吸烟、喝酒、息肉个人史、结肠癌家族史、大便习惯或性状改变等因素,干预结直肠癌高危人群参与结肠镜筛查的健康行为。

Objective To explore the current status and influencing factors of colonoscopy screening participation in high-risk population for colorectal cancer,and to provide insights for promoting proactive health management behaviors among individuals at high risk for colorectal cancer.Methods A total of 624 individuals aged 50 to 70 from Linping District,Hangzhou,who are at high risk for colorectal cancer,were selected as the study subjects.General information,colonoscopy screening participation among the high-risk population were investigated.Binary Logistic regression analysis was employed to identify the influencing factors of colonoscopy screening participation among the high-risk population for colorectal cancer.Results Among the 624 individuals at high risk for colorectal cancer,148 participated in colonoscopy screening,yielding a participation rate of 23.72%.The results of the multifactor analysis revealed that factors such as age,smoking,alcohol consumption,monthly household income,personal history of polyps,family history of colorectal cancer,changes in bowel habits or stool characteristics,medical insurance coverage,awareness of colorectal cancer-related symptoms,and health education were identified as independent risk factors for colonoscopy screening participation among the high-risk population for colorectal cancer(all P<0.05).Furthermore,a risk prediction model for colonoscopy screening participation among the high-risk population for colorectal cancer was constructed.The model fit test showed aχ^(2)=4.095 with a corresponding P=0.848.The AUC of the predictive model was 0.892(P<0.05).Conclusions Based on factors such as age,smoking,alcohol consumption,personal history of polyps,family history of colorectal cancer,and changes in bowel habits or stool characteristics,clinical interventions can be tailored to promote colonoscopy screening participation among individuals at high risk for colorectal cancer.