| 黄 铖,蔡滨欣,朱美英.大肠癌危险度评估问卷在社区筛查阳性居民次年复筛中的有效性分析[J].中国肿瘤,2019,28(7):487-493. |
| 大肠癌危险度评估问卷在社区筛查阳性居民次年复筛中的有效性分析 |
| Validity of Risk Assessment Questionnaire Among Residents with Positive Results Participating in Colorectal Cancer Screening in the Following Year |
| 投稿时间：2018-10-17 |
| DOI：10.11735/j.issn.1004-0242.2019.07.A002 |
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| 中文关键词: 大肠癌 筛查 危险度评估 问卷调查 |
| 英文关键词:colorectal cancer screening risk assessment questionnaire investigation |
| 基金项目:上海市高峰计划公共卫生与预防医学重点学科建设项目；上海市第四轮公共卫生三年行动计划慢病重点学科项目（15GWZK0801） |
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| 中文摘要: |
| 摘 要：［目的］ 描述上海市50～74岁社区大肠癌筛查阳性对象复筛时危险度评估问卷阳性条目前后两年应答的一致性，评价大肠癌危险度评估问卷的有效性。［方法］ 分析2015～2016年上海市松江佘山与新桥社区大肠癌筛查人群信息，描述初筛阳性居民次年再次筛查时大肠癌危险度评估问卷各条目阳性率变化情况，并利用Logistic回归分析危险度评估条目两年阳性应答一致性的影响因素。［结果］ 2015年，两社区共计18 051人参与大肠癌筛查项目，6205人（34.4%）初筛阳性，其中4093人（66.0%）再次参与次年筛查。首年报告阳性，次年报告阴性的情况在生活负性事件史（84.4%）及黏液血便史（81.3%）条目中发生率最高；个人癌症史（36.5%）、个人息肉史（44.3%）与一级亲属肠癌史（47.2%）阳性对象亦有次年报告不一致情况。2015年经肠镜检出的肠癌患者中，2/6次年未报告个人癌症史；息肉或腺瘤检出者中，35.8%（58/162）次年未报告肠息肉史。多因素Logistic回归提示，婚姻状况、是否吸烟、首年粪便隐血试验（FOBT）结果、蔬菜水果摄入量与运动情况是阳性条目两年报告不一致的主要影响因素。［结论］ 大肠癌筛查项目初筛阳性居民次年危险度再评估时，问卷原阳性条目存在误报，可探索建立大肠癌筛查数据信息平台，充分利用历年筛查信息，提高问卷评估的有效性。 |
| 英文摘要: |
| Abstract：［Purpose］ To evaluate the validity of risk assessment questionnaire among residents with positive results participating in colorectal cancer (CRC) screening in the following year among old residents in Shanghai.［Methods］ Data of CRC screening in two consecutive years (2015 and 2016) among residents aged 50～74 years in two communities of Shanghai Songjiang district were retrospectively reviewed. The changes in the positive items from risk assessment questionnaire in two years were analyzed. Logistic regression was employed to explore the factors related to the inconsistency reports of positive risk assessment items. ［Results］ Total 18 051 residents participated in the CRC screening program in 2015. Among them 6205(34.4%) were initially screened positive，and 4093 (66.0%) participated in the 2016 program again. Among participants reported positive results in 2015，84.4% with negative life events，81.3% with history of mucosanguineous feces，36.5% with history of cancers，44.3% with history of polyps and 47.2% with CRC history of first-degree relatives showed negative results in 2016. Among 6 CRC patients diagnosed by colonoscopy in 2015，2 did not report a personal cancer history in 2016； among 162 participants diagnosed as polyps or adenomas in 2015，58 (35.8%) did not report a personal history of intestinal polyps in the 2016. Multivariate Logistic regression revealed that marital status，smoking，FOBT results in the first year，fruit and vegetable intake，and physical activity were significantly associated with inconsistent reporting of the positive items.［Conclusion］ There are false reports in risk assessment items among re-screening residents. It is imperative to establish an effective information platform for CRC screening program and to make full use of previous screening data to improve the validity of the risk assessment questionnaire. |
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