2010-2022年淮河流域滕州市上消化道癌早诊早治项目筛查和随访结果分析

Results of screening and follow-up of early detection and treatment project for upper gastrointestinal cancer in Huaihe River basin of Tengzhou City from 2010 to 2022

目的分析2010-2022年淮河流域滕州市上消化道癌早诊早治项目的初筛和随访情况,掌握筛查结果的变化趋势。方法收集整理2010-2022年滕州市上消化道癌早诊早治项目相关数据,分别计算上消化道癌初筛和复查的检出率、早诊率和治疗率等指标。采用χ^(2)检验分析不同组间高危率、检出率、早诊率和治疗率的差异,采用趋势χ^(2)检验分析各年间筛查结果的变化趋势。结果2010-2022年滕州市共完成73282人次上消化道癌危险因素调查,总体高危率为45.85%(33598/73282);23478人次的内镜筛查和随访复查,其中初筛22925人次,复查553人次。初筛人群上消化道癌检出率、早诊率、治疗率分别为0.64%(147/22925)、76.87%(113/147)和74.15%(109/147),初筛人群中13年间的上消化道癌检出率、早诊率和治疗率变化差异均无统计学意义(趋势检验:检出率χ^(2)=2.62,P=0.106;早诊率χ^(2)=2.31,P=0.129;治疗率χ^(2)=1.07,P=0.302);复查人群检出率、早诊率、治疗率分别为4.52%(25/553)、80.00%(20/25)和60.00%(15/25),复查人群检出率显著高于初筛人群,χ^(2)=111.75,P<0.001。结论2010-2022年淮河流域滕州市上消化道癌风险率较高,整体检出率较低,需进一步完善规范化及长效化的筛查工作机制,开展癌症防控知识普及教育,实施针对性的干预措施,以期进一步提升项目筛查效果。

Objective To analyze the results of screening and follow-up of the early detection and treatment project for upper gastrointestinal cancer in Huaihe River basin of Tengzhou City from 2010 to 2022,and to grasp the changing trends of screening results.Methods Based on the cancer screening program conducted in Tengzhou City from 2010 to 2022,the databases of screening and follow-up were analyzed,while the detection rates,the early stage diagnosis rates and treatment rates were calculated respectively.Theχ^(2) test was used to analyze the differences between the high-risk rate,detection rate,early stage diagnosis rate and treatment rate among different groups,and the trendχ^(2) test was used to analyze the trend changes of high-risk rate,detection rate,early stage diagnosis rate and treatment rate in different years.Results A total of 73282 residents participated in upper gastrointestinal cancer risk assessment questionnaire from 2010 to 2022,and the high-risk rate was 45.85%(33598/73282);23478 person-times of endoscopic screening and follow-up review included 22925 person-times of initial screening and 553 person-times of follow-up review.Among the subjects in preliminary screening,the detection rate,early stage diagnosis rate and treatment rate were 0.64%(147/22925),76.87%(113/147)and 74.15%(109/147),respectively.There was no statistically significant difference in the detection rate,early diagnosis rate,and treatment rate of upper gastrointestinal cancer among the initial screening population over the 13-year period(the trendχ^(2) test:the detection rateχ^(2)=2.62,P=0.106;the early stage diagnosis rateχ^(2)=2.31,P=0.129;the treatment rateχ^(2)=1.07,P=0.302).Among the subjects in follow-up,the detection rate,early stage diagnosis rate and treatment rate were 4.52%(25/553),80.00%(20/25)and 60.00%(15/25),respectively.There was significant difference in the detection rate of upper gastrointestinal cancer among preliminary screening and follow-up(χ^(2)=111.75,P<0.001).Conclusions The risk rate of upper gastrointestinal cancer was higher in Tengzhou City of Huaihe River basin from 2010 to 2022,but the detection rate of upper gastrointestinal cancer in Cancer Screening Program was lower.We should take cancer screening as the focus of chronic disease prevention and control,further improve the standardized and long-term screening mechanism,strengthen publicity and education of cancer prevention knowledge,thus to improve the screening effectiveness.