| 李 科,梁颖茹,秦鹏哲,等.2015—2018年广州市40～74岁社区人群试点结直肠癌筛查结果分析[J].中国肿瘤,2023,32(1):39-45. |
| 2015—2018年广州市40～74岁社区人群试点结直肠癌筛查结果分析 |
| Results of Colorectal Cancer Screening Among Communitiy-dwelling Residents Aged 40～74 Years in Pilot Areas of Guangzhou Municipality from 2015 to 2018 |
| 投稿时间：2022-05-06 |
| DOI：10.11735/j.issn.1004-0242.2023.01.A007 |
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| 中文关键词: 结直肠癌 筛查 年龄 广东 |
| 英文关键词:colorectal cancer screening age Guangdong |
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| 中文摘要: |
| 摘 要：［目的］ 分析40~74岁不同年龄段人群结直肠癌筛查情况及肠镜检查结局，为调整结直肠癌筛查起始年龄提供科学依据和参考。［方法］ 收集、整理2015—2018年广州市40~74岁试点结直肠癌筛查数据，评价和比较40~74岁不同年龄段人群高危因素问卷调查（high-risk factor questionnaire，HRFQ）、粪便隐血试验（fecal occult blood test，FOBT）和全结肠镜检查的筛查效果。［结果］ 47 176人参与了筛查，初筛阳性10 608人，初筛阳性率22.49%；40~44岁、45~49岁、50~54岁和55~74岁年龄组初筛阳性率分别为21.91%（365/1 666）、20.87%（569/2 727）、20.80%（1 279/6 149）和22.92%（8 395/36 634），差异有统计学意义（P<0.001），其中女性55~74岁年龄组初筛阳性率22.58%(5 025/22 255)高于其他年龄组（P<0.001）。男、女性FOBT参与率高年龄组高于40~44岁和45~49岁年龄组（P<0.001）。初筛阳性者中，2 867人参与了肠镜检查，肠镜检查依从率27.03%（2 867/10 608），其中40~44岁(31.23%)、45~49岁(30.76%)和50~54岁年龄组(34.09%)肠镜检查依从率高于55~74岁年龄组（25.52%）（P<0.001）。肠镜下发现肠道病变1 399例，总体病变检出率48.80%，非进展性腺瘤、进展性腺瘤、结直肠癌检出率分别为15.84%（454/2 867）、12.56%（360/2 867）和2.27%(65/2 867)。不同年龄组肠道病变、非进展性腺瘤、进展性腺瘤检出率存在差异，男女性均随着年龄增加，肠道病变、非进展性腺瘤、进展性腺瘤检出率增加；45~49岁年龄组中非进展性腺瘤构成比较高，为61.8%；55~74岁年龄组肠癌检出构成比较高，为8.1%，但各年龄组差异无统计学意义（χ2=5.574，P=0.473）。［结论］ 广州市普通人群40~44岁、45~49岁与50~74岁年龄组人群有相似的结直肠癌发病风险，40~54岁肠镜检查顺应性较好，肠道病变中轻症构成较高。在对普通人群开展结直肠癌筛查中，可以考虑将筛查起始年龄提前至40岁或者45岁，以获得更好的社会和经济效益。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze colorectal cancer screening in population aged 40~74 years in Guangzhou pilot communities. ［Methods］ Data of pilot screening of colorectal cancer among community-dwelling residents in Guangzhou from 2015 to 2018 were collected. The results of high-risk factor questionnaire(HRFQ) survey， the positive rate of fecal occult blood test(FOBT) and the detection rate of colonoscopy were evaluated. ［Results］ There were 47 176 residents aged 40~74 years participating in the screening and 10 608 cases(22.49%) were identified as high risk by HRFQ. The positive rates of primary screening at age groups of 40～44， 45～49， 50～54 and 55～74 years were 21.91%(365/1 666)， 20.87%(569/2 727)， 20.80%(1 279/6 149) and 22.92%(8 395/36 634)， respectively(P<0.001). The positive rate of primary screening in women aged 55～74 years was higher than that in other age groups ［22.58%(5 025/22 255)， P<0.001］. The participation rate of age group of 55～74 years for FOBT test was higher than that at the 40～49 age groups(P<0.001). Colonoscopies were performed on 2 867 high risk cases(27.03%). The compliance rate of colonoscopy at age groups of 40～44 years(31.23%)， 45～49 years(30.76%) and 50～54 years(34.09%) was higher than that at age group of 55～74 years(25.52%)(P<0.001). Intestinal lesions were found in 1 399 cases(48.8%). The detection rates of non-progressive adenoma， progressive adenoma and colorectal cancer were 15.84%(454/2 867)， 12.56%(360/2 867) and 2.27%(65/2 867)， respectively. There were significant differences in the detection rates of intestinal lesions， non-progressive adenoma and progressive adenoma among different age groups. The detection rates of intestinal lesions， non-progressive adenoma and progressive adenoma increased with age in both men and women. The proportion of non-progressive adenoma at 45～49 age group was higher(61.8%). The proportion of colorectal cancer detected at 55～74 age group was 8.1%， but there was no significant difference in detection rate of colorectal cancer among different groups(χ2=5.574， P=0.473). ［Conclusion］ In the general population of Guangzhou， the risk of colorectal cancer was similar at age groups of 40~44， 45~49 and 50~74 years. The compliance of colonoscopy was better at 40~54 age group， and mild intestinal lesions accounted for a higher proportion. The screening of colorectal cancer in general population may start from age of 40 or 45 years for better social and economic benefits. |
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