宝山区居民结直肠癌筛查结果分析

Analysis of colorectal cancer screening results among residents in Baoshan District

目的分析2013—2021年上海市宝山区居民结直肠癌筛查结果,为完善结直肠癌筛查和防治策略提供依据。方法选择2013—2021年宝山区50~74岁常住居民为筛查对象,采用危险度评估表和粪便隐血检测进行初筛,危险度评估阳性或粪便隐血检测阳性为初筛阳性,初筛阳性者进行结肠镜检查;分析初筛阳性率、结肠镜检查依从率和结肠镜检查结果。结果2013—2021年宝山区完成结直肠癌初筛264907人,初筛阳性65333人,初筛阳性率为24.66%,其中危险度评估阳性率为12.16%,粪便隐血阳性率为14.64%。14473人完成结肠镜检查,依从率为22.15%。检出癌前病变1284例,检出率为8.87%;结直肠癌386例,检出率为2.67%。男性初筛阳性率、结肠镜检查依从率、癌前病变检出率和结直肠癌检出率分别为25.55%、23.12%、11.60%和3.62%,高于女性的24.06%、21.45%、6.74%和1.93%(均P<0.05)。随着年龄增长,初筛阳性率呈上升趋势,结肠镜检查依从率呈下降趋势,癌前病变检出率和结直肠癌检出率呈上升趋势(均P<0.05)。2013—2021年居民初筛阳性率呈下降趋势,结肠镜检查依从率呈上升趋势(均P<0.05)。结论2013—2021年宝山区结直肠癌癌前病变检出率为8.87%,结直肠癌检出率为2.67%,男性和高龄人群是筛查重点人群,居民结肠镜检查依从性有待提高。

Objective To analyze the results of colorectal cancer screening among residents in Baoshan District,Shang⁃hai Municipality from 2013 to 2021,so as to provide the basis for promoting colorectal cancer screening and preven⁃tion.Methods Permanent residents aged 50 to 74 years in Baoshan District from 2013 to 2021 were selected as the screening population.The initial screening was conducted using a risk assessment form and fecal occult blood test.Posi⁃tive results on either the risk assessment form or fecal occult blood test were considered positive for the initial screen⁃ing.Participants with positive initial screening results were invited to undergo colonoscopy.The positive rate of the ini⁃tial screening,colonoscopy compliance rate,and colonoscopy results were analyzed.Results A total of 264907 individ⁃uals underwent the initial colorectal cancer screening in Baoshan District from 2013 to 2021,with 65333 individuals(24.66%)testing positive.Among them,the positive rate of the risk assessment form was 12.16%,and the positive rate of fecal occult blood test was 14.64%.A total of 14473 individuals completed colonoscopy,with a compliance rate of 22.15%.A total of 1284 precancerous lesions were detected,with a detection rate of 8.87%,and 386 cases of colorec⁃tal cancer were identified,with a detection rate of 2.67%.The positive rate of the initial screening,colonoscopy compli⁃ance rate,precancerous lesion detection rate,and colorectal cancer detection rate were higher in males than in females(25.55%vs.24.06%,23.12%vs.21.45%,11.60%vs.6.74%,3.62%vs.1.93%,all P<0.05).With increasing age,the positive rate of the initial screening increased,the colonoscopy compliance rate decreased,the precancerous lesion detec⁃tion rate and colorectal cancer detection rate increased(all P<0.05).From 2013 to 2021,the positive rate of the initial screening among residents showed a downward trend,while the colonoscopy compliance rate showed an upward trend(both P<0.05).Conclusions The detection rate of precancerous lesions in colorectal cancer was 8.87%,and the detec⁃tion rate of colorectal cancer was 2.67%in Baoshan District from 2013 to 2021.Male and older individuals were the key populations for screening,and the colonoscopy compliance among residents needs to be improved.