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[2015 - 2016年广州市50 - 74岁人群社区结直肠癌筛查分析]

[Analysis of community colorectal cancer screening in 50-74 years old people in Guangzhou, 2015-2016].

作者信息

Li Y, Liu H Z, Liang Y R, Lin G Z, Li K, Dong H, Xu H, Wang M

机构信息

Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Jan 10;39(1):81-85. doi: 10.3760/cma.j.issn.0254-6450.2018.01.017.

Abstract

To analyze the effect of colorectal cancer screening in the general population in Guangzhou, and provide evidence for the for development of colorectal cancer screening policy and strategy. The data of colorectal cancer screening in Guangzhou during 2015- 2016 were collected. The participation, the positive rate of fecal occult blood test, the detection rate of colonoscopy and screening effect of colonoscopy were evaluated. A total of 220 834 residents aged 50-74 years received the screening, and the positive rate of the screening was 16.77% (37 040 cases). Colonoscopy was performed for 7 821 cases (21.12%). Colorectal lesions were found in 4 126 cases (52.76%), of which 614 (7.85%) and 73 (0.93%) and 230 (2.94%) were identified as advanced adenoma, severe dysplasia lesions and colorectal cancers, respectively. The detection rates of all colorectal lesions were higher in men than in women (all <0.01). The diagnostic rate of early lesion was 87.24%, and 99 early cancer cases were found, accounting for 46.26% of the total cases. The overall screening detection rate of colorectal cancer was 104.15/100 000, higher than the incidence rate (81.18/100 000) in colorectal cancer surveillance (<0.001), but age group <70 years had higher detection rate, age group ≥70 years had higher incidence rate. The colorectal cancer screening strategy in Guangzhou is effective in the detection of the population at high risk, increase the detection rate of colorectal lesions, early diagnosis rate of precancerous lesions and diagnosis rate of early colorectal cancer. The benefit in those aged ≤69 years was more obvious than that in those aged 70-74 years. It is necessary to improve the compliancy of colorectal cancer screening in population at high risk.

摘要

分析广州市普通人群结直肠癌筛查效果,为制定结直肠癌筛查政策和策略提供依据。收集广州市2015 - 2016年结直肠癌筛查数据,评估参与率、粪便潜血试验阳性率、结肠镜检查检出率及结肠镜检查筛查效果。共有220834名50 - 74岁居民接受筛查,筛查阳性率为16.77%(37040例)。7821例(21.12%)接受结肠镜检查。4126例(52.76%)发现结直肠病变,其中614例(7.85%)、73例(0.93%)和230例(2.94%)分别被诊断为高级别腺瘤、重度异型增生病变和结直肠癌。男性所有结直肠病变检出率均高于女性(均P<0.01)。早期病变诊断率为87.24%,发现99例早期癌病例,占总病例数的46.26%。结直肠癌总体筛查检出率为104.15/10万,高于结直肠癌监测发病率(81.18/10万)(P<0.001),但<70岁年龄组检出率较高,≥70岁年龄组发病率较高。广州市结直肠癌筛查策略对高危人群检测有效,提高了结直肠病变检出率、癌前病变早期诊断率和早期结直肠癌诊断率。≤69岁人群获益比70 - 74岁人群更明显。有必要提高高危人群结直肠癌筛查的依从性。

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