Song Dawei, Huang Rui, Ma Tianyi, Chen Yinggang, Li Jiaying, Wang Xishan
Department of Colorectal Tumor Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin 150086, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2016 Oct 25;19(10):1139-1143.
To evaluate the result of colorectal cancer screening for high-risk groups in Harbin, China from 2012 to 2015.
According to the Project of National Colorectal Cancer Screening in Urban Area, epidemiological investigation and cancer risk evaluation established by National Cancer Center were performed among 40-69 years old residents in Harbin. Questionnaires were issued to assess high-risk groups for clinical screening, including colonoscope examination. The results of colorectal screening were evaluated in detail.
Project of Colorectal Cancer Screening in Urban Area was completed successfully from 2012 to 2015 in various districts of Harbin. The accomplishment of high-risk assessment included 3 017 people, while 2 996 people received the clinical screening, including 1 376 males and 1 629 females, from 40 to 69 (53.3±7.1) years old. Among 2 996 people, 1 158 cases of colorectal polyps(38.7%) were screened, including 36.6%(901/2 465) cases of age<60 and 48.4%(257/531) cases of age>60 years old with significant difference (χ=19.19, P<0.01), and 47.6% (651/1 367) cases of male and 31.1%(507/1 629) cases of female with significant difference (χ=85.33, P<0.01). Of 1 158 polyps patients, 141 received the pathological examination and 11 patients were diagnosed as colorectal cancer, accounting for 0.4% of overall screening people (11/2 996). All these 11 patients underwent operation by advice and the postoperative pathology results all indicated early adenocarcinoma. Furthermore, among 141 polyps patients, 97 cases of tubular adenoma were found, which were distributed as follows: 2 cases of cecum (2.1%), 14 cases of ascending colon(14.4%), 12 cases of transverse colon (12.4%), 15 cases of descending colon (15.5%), 35 cases of sigmoid colon (36.1%) and 19 cases of rectum(19.6%).
With the increase in age, the risk of colorectal polyps is significantly elevated. The males have higher incidence of colorectal polyps than the females. Adenoma mainly locates in the distal colon and rectum, especially in the sigmoid colon. Early screening for high-risk group can find out colorectal precancerosis and cancer, so the patients can receive early treatment.
评估2012年至2015年中国哈尔滨高危人群的结直肠癌筛查结果。
根据国家城市地区结直肠癌筛查项目,对哈尔滨40 - 69岁居民进行了由国家癌症中心制定的流行病学调查和癌症风险评估。发放问卷以评估临床筛查的高危人群,包括结肠镜检查。详细评估了结直肠癌筛查结果。
2012年至2015年哈尔滨市各城区成功完成了城市地区结直肠癌筛查项目。高危评估完成3017人,2996人接受了临床筛查,其中男性1376人,女性1629人,年龄40至69(53.3±7.1)岁。在2996人中筛查出1158例结直肠息肉(38.7%),其中年龄<60岁者占36.6%(901/2465),年龄>60岁者占48.4%(257/531),差异有统计学意义(χ=19.19,P<0.01);男性占47.6%(651/1367),女性占31.1%(507/1629),差异有统计学意义(χ=85.33,P<0.01)。1158例息肉患者中,141例接受了病理检查,11例被诊断为结直肠癌,占总筛查人数的0.4%(11/2996)。这11例患者均按建议接受了手术,术后病理结果均提示早期腺癌。此外,141例息肉患者中发现97例管状腺瘤,分布如下:盲肠2例(2.1%),升结肠14例(14.4%),横结肠12例(12.4%),降结肠15例(15.5%),乙状结肠35例(36.1%),直肠19例(19.6%)。
随着年龄的增加,结直肠息肉的风险显著升高。男性结直肠息肉的发病率高于女性。腺瘤主要位于结肠远端和直肠,尤其是乙状结肠。对高危人群进行早期筛查可发现结直肠癌前病变和癌症,使患者能够接受早期治疗。