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山东省结直肠癌高危人群结肠镜筛查依从性分析

Analysis of Colonoscopy Screening Adherence among High-Risk Populations for Colorectal Cancer in Shandong Province

投稿时间：2026-03-27 修订日期：2026-06-23

DOI：

中文关键词: 结直肠癌筛查影响因素结肠镜检查依从性山东省

英文关键词:colorectal cancer screening influencing factors colonoscopy adherence Shandong Province

基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目）；中国消化道早癌医师共同成长计划科研项目；山东省医药卫生科技项目

作者	单位	邮编
张铭君	公共卫生学院	261053
李锡瑞	山东省肿瘤防治研究院（山东省肿瘤医院）,山东第一医科大学（山东省医学科学院	250117
柳言	山东第一医科大学附属肿瘤医院	250117
刘博宇	山东第一医科大学（山东省医学科学院）	250117
孙甜	山东第一医科大学（山东省医学科学院）	250117
刘彦秀	山东第一医科大学附属肿瘤医院	250117
张楠	山东第一医科大学附属肿瘤医院	250117
路友华^*	山东第一医科大学附属肿瘤医院	250117

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中文摘要:

[目的] 分析山东省结直肠癌高危人群结肠镜筛查依从性现状及其影响因素。[方法] 选取2024年10月—2025年8月山东省重点人群结直肠癌筛查试点工作中参加筛查完成初筛并评估为高风险的50273名居民作为研究对象。采用χ2检验比较不同特征人群结肠镜筛查依从性的差异；构建多因素Logistic回归模型分析影响结肠镜筛查依从性的因素。[结果] 50273名初筛高风险人群中，6035人接受结肠镜检查（依从率为12.00%），多因素logistic回归分析结果显示，教育程度为初高中（OR=1.293，95%CI=1.191-1.405）、高中以上（OR=1.274，95%CI=1.138-1.427）、吸烟（OR=1.165，95%CI=1.088-1.248）、每周锻炼3-5次或每天锻炼（OR=1.140，95%CI=1.070-1.215）人群的依从性更高；存在肠道异常症状（OR=1.897，95%CI=1.766-2.038）、既往接受过结肠镜检查（OR=1.318，95%CI=1.215-1.429）及有结直肠癌家族史（OR=1.572，95%CI=1.432-1.726）的人群更愿意接受结肠镜检查。与40-49岁人群相比，70-74岁（OR=0.755，95%CI=0.654-0.871）人群的依从性更低；城区（OR=0.829，95%CI=0.778-0.882）及参加城镇职工基本医疗保险（OR=0.917，95%CI=0.856-0.983）的人群，其结肠镜检查的依从性更低。[结论] 山东省结直肠癌高危人群的结肠镜筛查依从性较低，仍亟待提高。未来应针对高龄、低学历及城镇职工等低依从性特征群体制定精准的干预与随访策略，以有效打破筛查壁垒，提升高危人群的结肠镜筛查依从性。

英文摘要:

[Purpose] To analyze the current status of colonoscopy screening adherence and its influencing factors among colorectal cancer high-risk individuals in Shandong Province. [Methods] A total of 50,273 residents who participated in the colorectal cancer screening pilot program for key populations in Shandong Province, completed initial screening, and were assessed as high-risk individuals from October 2024 to August 2025 were selected as study subjects. The χ² test was used to compare differences in colonoscopy screening adherence among populations with different characteristics, and a multivariable Logistic regression model was constructed to analyze factors influencing colonoscopy screening adherence. [Results] Among the 50,273 initial screening high-risk individuals, 6,035 underwent colonoscopy (adherence rate: 12.00%). Multivariable logistic regression analysis showed that individuals with junior or senior high school education (OR=1.293, 95%CI=1.191–1.405), an education level above high school (OR=1.274, 95%CI=1.138–1.427), smoking (OR=1.165, 95%CI=1.088–1.248), and exercising 3–5 times per week or daily (OR=1.140, 95%CI=1.070–1.215) had higher colonoscopy adherence. Individuals with intestinal symptoms (OR=1.897, 95%CI=1.766–2.038), previous colonoscopy experience (OR=1.318, 95%CI=1.215–1.429), and a family history of colorectal cancer (OR=1.572, 95%CI=1.432–1.726) were more likely to undergo colonoscopy. Compared with individuals aged 40–49 years, those aged 70–74 years (OR=0.755, 95%CI=0.654–0.871) had lower adherence. Lower colonoscopy adherence was observed among individuals who were unmarried/divorced/widowed (OR=0.853, 95%CI=0.724–1.005), lived in urban areas (OR=0.829, 95%CI=0.778–0.882), or participated in Urban Employee Basic Medical Insurance (UEBMI) (OR=0.917, 95%CI=0.856–0.983). [Conclusion] Colonoscopy screening adherence among colorectal cancer high-risk individuals in Shandong Province is relatively low and requires further improvement. Future efforts should develop targeted intervention and follow-up strategies for low-adherence groups, including older individuals, those with lower educational levels, and individuals covered by UEBMI, to effectively overcome screening barriers and improve colonoscopy screening adherence among high-risk populations.

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