| 姜春晓,沈永洲,张志浩.结直肠癌和癌前病变检出率与其危险因素关系[J].中国肿瘤,2017,26(11):868-873. |
| 结直肠癌和癌前病变检出率与其危险因素关系 |
| Relationship Between the Risk Factors and Detection Rates of Colorectal Cancer and Precancerous Lesions |
| 投稿时间：2016-11-03 |
| DOI：10.11735/j.issn.1004-0242.2017.11.A006 |
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| 中文关键词: 结直肠癌 癌前病变 人群筛查 检出率 危险因素 |
| 英文关键词:colorectal cancer precancerous lesions population screening detection rate risk factors |
| 基金项目:浙江省公益性应用研究项目（2013C33217） |
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| 摘要点击次数: 1940 |
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| 中文摘要: |
| 摘 要：［目的］ 探索结直肠癌各类危险因素与结直肠癌及其癌前病变检出率关系，为合理制定结直肠癌筛查策略与防控措施提供科学依据。［方法］ 基于海宁市2010～2012年40～74岁目标人群结直肠癌筛查信息，分析各类危险因素与结直肠癌及癌前病变检出率关系。［结果］危险因素量化评估问卷调查240 177人，筛查顺应率为88.25%，病史阳性率6.09%；两次大便隐血试验（FOBT）388 780份，阳性21 079份，阳性率5.42%，初筛确定高危人群33 624人，占筛查人数的13.85%；高危人群结肠镜检查24 046例，顺应率为76.01 %；共检出肠道病变（息肉、腺瘤、癌、溃疡）6552例（其中结直肠癌119例，进展期腺瘤1042例），总检出率为27.25%。男性检出率明显高于女性(P<0.01)；检出率随年龄增长而上升（趋势检验，P<0.01），70岁年龄组的检出率比40岁组高出1倍左右。多因素非条件Logistic回归分析表明：年龄大(OR=1.103，95%CI：1.075～1.133，P=0.000)，大便隐血试验（FOBT）阳性（OR=4.470 95%CI：2.129～9.385，P=0.000），有慢性阑尾炎或手术史(OR=0.445，95%CI：0.199～0.996，P=0.049)，结直肠息肉史（OR=0.225，95%CI：0.051～0.995，P=0.049）与结直肠癌检出率存在统计关联。［结论］ 应加强对有黏液血便、有慢性阑尾炎或手术史、结直肠息肉史、大便隐血试验阳性的老年男性的结直肠癌筛查。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the relationship between the risk factors of colorectal cancer and the detection rate of colorectal cancer and precancerous lesions. ［Methods］ Based on the data of colorectal cancer screening for general population aged 40~74 years in Haining City at 2010~2012，the relationship between risk factors and the detection rate of colorectal cancer and precancerous lesions was analyzed. ［Results］ A questionnaire survey on quantitative assessment of risk factors was conducted among 240 177 subjects aged 40～74 years with a response rate of 88.25%，and a positive rate of history of 6.09%. The fecal occult blood tests(FOBT) were performed in 388 780 subjects and 21 079 were positive with a positive rate of 5.42%. Total 33 624 subjects were identified as the high risk population，accounting for 13.85% of participants in screening. Colonoscopy was performed in 24 046 cases，with compliance rate of 76.01%；6552 cases with intestinal lesions (polyps，adenoma and carcinoma，ulcer) were detected，including 119 cases of colorectal cancer and 1042 cases of advanced adenoma with a detection rate of 27.25%. The detection rate in males was higher than that in females (P<0.01)；the detection rate increased with the age (trend test，P<0.01)，and the detection rate in 70 years age group was twice higher than that in 40 years age group. Multivariate non-conditional Logistic regression analysis showed that age(OR=1.103，95%CI：1.075~1.133，P=0.000)；FOBT positive (OR=4.470，95%CI：2.129~9.385，P=0.000)；chronic appendicitis or surgery history(OR=0.445，95% CI：0.199~0.996，P=0.049)；the history of colorectal polyps（OR=0.225，95%CI：0.051～0.995，P=0.049）were significantly associated with detection rate of colorectal cancer. ［Conclusion］ Attention should be paid for elderly males with mucosanguineous stool，history of chronic appendicitis or excision，history of intestinal polyps and positive FOBT in screening of colorectal cancer. |
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