| 李 娟,李其龙,薛 峰.粪便潜血试验和问卷调查在人群结直肠癌筛查中的应用评价[J].中国肿瘤,2015,24(5):385-389. |
| 粪便潜血试验和问卷调查在人群结直肠癌筛查中的应用评价 |
| Application of Faecal Occult Blood Testing and Questionnaire Risk Assessment in Population Screening for Colorectal Cancer |
| 投稿时间：2014-12-01 |
| DOI：10.11735/j.issn.1004-0242.2015.05.A008 |
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| 中文关键词: 结直肠肿瘤 优化序贯筛查 阳性预测值 |
| 英文关键词:colorectal neoplasms optimized sequential screening positive predictive value |
| 基金项目:浙江省医药卫生科技项目（2011KYB123） |
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| 中文摘要: |
| 摘 要：［目的］ 分析粪便潜血试验、危险因素数量化评估问卷调查在人群结直肠癌筛查中的应用价值。［方法］ 嘉善县2007年5月至2013年12月7个镇（街道）目标人群进行结直肠癌优化序贯筛查方案，即采用危险因素数量化评估问卷调查和粪便潜血试验作为初筛方案，完成结直肠癌筛查完成初筛117 130人，其中问卷调查116 153人，粪便潜血试验99 268人。通过初筛确定高危人群19 078人，最终有14 709人完成了结肠镜检查。［结果］ 在14 709人肠镜检查中，共检出结直肠癌148人，进展期腺瘤692人，非进展期腺瘤1590人。优化序贯筛查方案和粪便潜血试验对结直肠癌、进展期腺瘤和非进展期腺瘤的阳性预测值分别为1.01%、4.70%，10.81% 和1.68%、6.22%和12.42%。问卷调查对结直肠癌、进展期腺瘤的阳性预测值明显低于优化序贯筛查方案，分别为0.50%、3.30%。如果筛查方案中去除慢性腹泻、慢性便秘、黏液便或血便史、不良生活事件史4个单项，对结直肠癌、进展期腺瘤、非进展期腺瘤的阳性预测值略有提高，能减少12.28%的肠镜检查量。［结论］ 我国现行的大肠癌优化序贯筛查方案对结直肠癌和进展期腺瘤有较高的阳性预测值，对非进展期腺瘤无明显效果，有进一步优化的必要和空间。 |
| 英文摘要: |
| Abstract： ［Purpose］ To investigate the role of faecal occult blood testing(FOBT) and questionnaire risk assessment (QRA) in screening for colorectal cancer. ［Methods］ The target population for colorectal cancer screening program in seven towns of Jiashan county were completed first screening which were used with FOBT and QRA from May 2007 to December 2013，117 130 people underwent first screening including 116 153 people with QRA and 99 268 people with FOBT. A total of 19 078 people were intended with the high risk people，and finally 14 709 people underwent the colonoscopy. ［Results］ Of the 14 709 people who undergoing colonoscopy，148 cases with colorectal cancer，692 cases with advanced adenomas，and 1590 cases with non-advanced adenomas were found. The positive predictive value(PPVs) for predicting colorectal cancer，advanced adenoma and non-advanced adenoma of the strategy with FOBT alone(1.01%，4.70% and 10.81%，respectively) were inferior to that of strategy with combined FIT and QRA(1.68%，6.22% and 12.42%，respectively). The PPVs of the strategy with combined FIT and QRA for predicting colorectal cancer and advanced adenoma were better than that of the strategy with QRA alone(3.30% and 0.50%，respectively). For individual risk factors in QRA，deletion of four risk factors overall improved all PPVs and dispensed 12.28% of colonoscopy. ［Conclusion］ Current colorectal cancer screening guideline(combined FOBT and QRA) has acceptable PPVs for predicting colorectal cancer and advanced adenoma，but it is insufficient for predicting non-advanced adenoma and needs to be further improved. |
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