| 李 燕,梁颖茹,刘华章.广州市社区人群大肠癌筛查的城乡差异及原因探讨[J].中国肿瘤,2018,27(4):273-278. |
| 广州市社区人群大肠癌筛查的城乡差异及原因探讨 |
| Urban-rural Differences of Colorectal Cancer Screening in Guangzhou |
| 投稿时间：2017-12-12 |
| DOI：10.11735/j.issn.1004-0242.2018.04.A006 |
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| 中文关键词: 肠肿瘤 筛查 城乡差异 广东 |
| 英文关键词:colorectal neoplasms screening urban-rural differences Guangdong |
| 基金项目:广州市科技计划项目（201707010205） |
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| 中文摘要: |
| 摘 要：［目的］ 分析广州市农村地区和城市地区大肠癌的筛查结果，探讨大肠癌筛查的城乡差异及可能的原因，为今后大肠癌筛查的策略调整和方法改进提供依据和思路。［方法］ 收集、整理广州市大肠癌筛查数据，统计分析问卷调查、大便潜血检查（FOBT）和全结肠镜检查的筛查效果。［结果］ 2015~2016年广州市在50~74岁重点人群中完成初筛220 834人，全市初筛阳性37 040人（16.77%），农村地区人群初筛阳性率（11.30%）低于城市地区（19.52%）（P<0.001）。全结肠镜检查7821人（21.12%），农村地区肠镜检查顺应性率（15.72%）明显低于城市地区（22.68%）（P<0.001）。农村地区总病变检出率、伴中/重度异型增生的其他病变检出率以及病变早诊率均高于相应城市地区（P<0.001）。肠镜下检出大肠癌230例（2.94%），农村地区（3.44%）和城市地区（2.84%）无统计学差异。和各自地区大肠癌监测发病率相比（50~74岁），城市地区大肠癌筛查发现率（125.78/10万）高于相应监测发病率（85.63/10万）（P<0.001），农村地区大肠癌筛查发现率和相应监测发病率无统计学差异。［结论］ 广州市大肠癌筛查结果存在明显的城乡差异，在大肠癌筛查过程中，政府应制定有针对性的措施，合理利用卫生资源，提高农村地区的筛查效益。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the urban-rural differences of colorectal cancer screening in Guangzhou. ［Methods］ Data of colorectal cancer screening during 2015~2016 in Guangzhou were collected. The participation，positive rate of fecal occult blood test（FOBT），the detection rate of colonoscopy and screening effects of colonoscopy were evaluated. ［Results］ Among 220 834 residents aged 50～74 years who participated in the colorectal cancer screening，37 040 cases（16.77%）were identified as high risk，the positive rate（11.30%）in rural areas was lower than that in urban area（19.52%）（P<0.001）. Colonoscopies were performed on 7821 cases（21.12%），the detection rate of colonoscopy in rural area（15.72%）was lower than that in urban area（22.68%）（P<0.001）. The detection rate of all lesions，the severe dysplasia and the early diagnostic rate in rural area were higher than that in urban area（P<0.001）. Two hundred and thirty cases of colorectal cancer（2.94%） were found，there was no statistic difference in detection rates between the rural area and urban area（3.44% vs 2.84%，P>0.05）. The screening detection rate of colorectal cancer in urban area was 125.78/105，which was higher than the colorectal cancer incidence 85.63/105（50～74 years）（P<0.001）；while there was no statistic difference between the screening detection rate and the incidence of colorectal cancer in rural area. ［Conclusion］ The result of colorectal cancer screening is significantly different between urban and rural areas in Guangzhou，suggesting that measures should be taken to promote the screening efficiency in rural areas. |
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