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| 2007-2024年江苏省淮河流域肝癌早诊早治项目筛查结果 |
| Screening Outcomes of the Liver Cancer Early Diagnosis and Treatment Program in the Huaihe River Basin, Jiangsu Province, 2007–2024 |
| 投稿时间：2026-05-11 修订日期：2026-06-15 |
| DOI： |
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| 中文关键词: 肝癌 筛查 淮河流域 江苏 |
| 英文关键词:Liver cancer Screening Huaihe River Basin Jiangsu |
| 基金项目:四大慢病重大专项（2024ZD0524003） |
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| 摘要点击次数: 12 |
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| 中文摘要: |
| [目的] 分析2007-2024年江苏省淮河流域肝癌早诊早治项目的筛查结果，评估项目在肝癌高发区人群中的实施效果。[方法] 基于淮河流域肝癌早诊早治项目数据，纳入2007-2024年江苏省项目地区参与筛查的35～74岁常住居民。采用问卷调查、体格检查和乙肝表面抗原（HBsAg）检测的方式进行肝癌风险评估。高风险人群接受腹部B超和甲胎蛋白（AFP）联合筛查。分别基于筛查人次数和筛查人数分析高风险率、筛查依从率、肝癌检出率、早诊率等指标，组间比较采用χ2检验，趋势分析采用Cochran-Armitage检验。[结果] 2007-2024年，项目共纳入分析282 861人（351 985人次）。基于人次统计，高风险率为33.30%（117 214/351 985），筛查依从率为72.59%（85 086/117 214），共检出肝癌583例，可疑肝癌555例，肝癌检出率为0.69%，早期肝癌比例为65.18%（380/583）。男性高风险率及肝癌检出率均高于女性（P＜0.001），但筛查依从率低于女性。HBsAg阳性人群肝癌检出率（0.90%）显著高于阴性人群（0.08%），相差约10.83倍（χ2=259.072,P＜0.001）。年龄越大，高风险率、筛查依从率和肝癌检出率越高。不同时期比较，筛查依从率从2007-2010年的29.83%升至2021-2024年的94.94%（Z=194.3，P＜0.001）。基于人数统计，高风险率为28.16%（79 667/282 861），筛查依从率为59.33%（47 267/79 667），共检出肝癌315例，可疑肝癌288例，肝癌检出率为0.67%。随着参与筛查次数增加，高风险率、筛查依从率及肝癌检出率均呈上升趋势，参与4次及以上人群的高风险率及筛查依从率均超过90%。[结论] 江苏省淮河流域肝癌早诊早治项目持续运行18年，公共卫生效益显著。男性、高龄及HBsAg阳性人群是肝癌筛查的重点关注对象。建议持续加强癌症防治知识普及，推动高危人群形成规律性、自主性筛查行为。 |
| 英文摘要: |
| [Purpose] To analyze the screening outcomes of the early diagnosis and treatment program for liver cancer in the Huaihe River Basin of Jiangsu Province from 2007 to 2024, evaluate the program''s implementation effectiveness among populations in high-incidence areas of liver cancer.[Methods] Based on data from the Huaihe River Basin Early Diagnosis and Treatment Program for liver cancer, permanent residents aged 35～74 years who participated in screening in the project areas of Jiangsu Province from 2007 to 2024 were enrolled. Liver cancer risk assessment was conducted using questionnaires, physical examinations, and hepatitis B surface antigen (HBsAg) testing. High-risk individuals received combined screening with abdominal ultrasound and alpha-fetoprotein (AFP) testing. Indicators including high-risk rate, screening compliance rate, liver cancer detection rate, and early diagnosis rate were analyzed based on both screening person-times and screening person-counts. Intergroup comparisons were performed using the chi-square test, and trend analysis was conducted using the Cochran-Armitage test.[Results] From 2007 to 2024, a total of 282,861 individuals (351,985 person-times) were included in the analysis. Based on person-times, the high-risk rate was 33.30% (117 214/351 985), and the screening compliance rate was 72.59% (85 086/117 214). A total of 583 liver cancer cases and 555 suspected liver cancer cases were detected, yielding a liver cancer detection rate of 0.69%, with early-stage liver cancer accounting for 65.18% (380/583). The high-risk rate and liver cancer detection rate were significantly higher in males than in females (both P < 0.001), whereas the screening compliance rate was lower in males. The liver cancer detection rate among HBsAg-positive individuals (0.90%) was significantly higher than that among HBsAg-negative individuals (0.08%), representing an approximately 10.83-fold difference (χ2 = 259.072, P < 0.001). Higher age was associated with increased high-risk rates, screening compliance rates, and liver cancer detection rates. Over different time periods, the screening compliance rate increased from 29.83% in 2007-2010 to 94.94% in 2021-2024 (Z = 194.3, P < 0.001). Based on person-counts, the high-risk rate was 28.16% (79,667/282,861), the screening compliance rate was 59.33% (47 267/79 667), and a total of 315 liver cancer cases and 288 suspected liver cancer cases were detected, with a liver cancer detection rate of 0.67%. With an increasing number of screening participations, the high-risk rate, screening compliance rate, and liver cancer detection rate all showed upward trends. Among individuals who participated in four or more screenings, both the high-risk rate and screening compliance rate exceeded 90%.[Conclusion] The early diagnosis and treatment program for liver cancer in the Huaihe River Basin of Jiangsu Province has been operating continuously for 18 years and has yielded significant public health benefits. Males, elderly individuals, and HBsAg-positive populations are key target populations for liver cancer screening. It is recommended to continuously strengthen the dissemination of cancer prevention knowledge and promote regular, voluntary screening behaviors among high-risk populations. |
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