社区常见恶性肿瘤筛查研究

Series Ⅲ Public Cancer Screening in China

目的探寻一种简便的恶性肿瘤初筛自查方法。方法将人体肿瘤分为三类:体表肿瘤约占15％;空腔脏器肿瘤占65％;深层实体脏器肿瘤20％。通过科普宣传教育,让群众学会自查体表部位肿瘤,每年用自查盒助查各空腔脏器有无微量出血,隐血阳性时,去医院进一步精查。北京部分大学选40～70岁居民1万人,分成试验组、对照组各5千人。结果试验四年后:试验组共查出79例癌,年平均癌检出率482.5人/10万,癌死亡率为12.2/10万;对照组癌死亡率206.2人/10万,两组有显著性差异。在癌症高发区,同时作扩大普查试验:广东四会市肿瘤所,在门诊普查1669人,检出25例癌,鼻咽癌占24例。1999～2000年,江苏省食管胃癌高发区,普查近8万人,检出480例癌。加上“九五”以前的普查统计,用秦氏自查盒已筛查431075人,检出1272例癌,癌前病变1万多例。结论试验证明该方案设计合理,在当前是一种最简便的恶性肿瘤初筛自查方法。

Purpose To assess the result of Series Ⅲ Public Cancer Screening in China. Methods and Results Human cancers can be divided into 3 types: Surface cancer (15%) .Hollow organ cancer (65%) and Deep seated solid organ cancer (20%) .Through education programmes, the general population was taught to self- examine the body surface and to use self- exam kit to detect any accult blood given out from the hollow organs.On discovering positive or doubtful results, these subjects were referred to the hospital for a complete clinical check -up. A total of 10 000 people with ages 40-70 years chosen from the university areas in Beijing was divided into a test group (5 000) and a control group (5 000) .This study as carried out for four years, showed that 79 cancers were discovered in the test group, with an annual cancer detection rate of 482.5/105 and a cancer mortality rate of 12.2/105 .The control group gave an annual cancer mortality rate of 206/105. The difference has very marked statistical significance ( P < 0.001) . During the same interval, an extensive cancer screening was carried out in the high -incidence areas. The Cancer Institute in Sihui city of Guangdong province discovered, by screening 758 in the OPD during a period of two years, 16 cancers with 15 as nasopharyngeal cancer. From 1999 - 2000, another extensive public cancer screening in the high incidence areas in Jiangsu province discovered 480 cancers from a 80 000 population. Together with the screening test carried out by Qin' s self- exam kit before the ninth Five - year Plan on 431 075 population, 1 272 cancers and more than 10 000 pie - cancerous lesions have been detected. Conclusion The Qin' s self- exam kit and public cancer screening are highly important in the practice of public cancer screening.