| 范习康,丁 慧,陆赛博,等.江苏省结直肠癌高危人群结肠镜检查依从性及其影响因素分析[J].中国肿瘤,2023,32(3):202-208. |
| 江苏省结直肠癌高危人群结肠镜检查依从性及其影响因素分析 |
| Study on Compliance Rate of Colonoscopy Among High-Risk Population of Colorectal Cancer in Jiangsu Province |
| 投稿时间：2022-08-01 |
| DOI：10.11735/j.issn.1004-0242.2023.03.A007 |
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| 中文关键词: 结直肠癌 筛查 高危人群 结肠镜 依从性 江苏 |
| 英文关键词:colorectal cancer screening high-risk population colonoscopy compliance Jiangsu |
| 基金项目:江苏省卫生健康委老年健康科研课题（LKM2022006） |
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| 中文摘要: |
| 摘 要：［目的］ 分析江苏省结直肠癌高危人群对结肠镜检查的依从性，探索影响结肠镜检查依从性的相关影响因素。［方法］ 基于2020年10月至2021年7月开展的江苏省社区居民结直肠癌高危人群筛查项目，本研究共纳入3 154名高危人群，通过秩和检验和χ2检验比较是否参加结肠镜检查两组人群间的差异；通过多因素Logistic回归模型分析影响结肠镜、常规结肠镜和无痛结肠镜检查依从性的相关因素。［结果］ 3 154名高危人群中，628名（19.91%）接受结肠镜检查，其中212名接受无痛结肠镜检查，412名接受常规结肠镜检查，4名“是否无痛”信息缺失；2 526名（80.09%）未接受结肠镜检查，不接受结肠镜检查的首位原因是担心不适。与未接受结肠镜检查者相比，接受结肠镜检查者男性、高学历者、问卷和便隐血试验均阳性［high risk factor questionnaire positive and fecal occult blood test positive，HRFQ(+) & FOBT(+)］者比例更高（P<0.05）。多因素Logistic回归分析结果显示，与女性相比，男性更愿意接受结肠镜检查（OR=1.57，95%CI：1.27~1.94）和常规结肠镜检查（OR=1.65，95%CI：1.26~2.16）；与文盲相比，学历为大专及以上者更愿意接受结肠镜检查（OR=1.93，95%CI：1.08~3.40）；与高危判定依据为仅问卷阳性［HRFQ(+) & FOBT(-)］者相比，仅FOBT阳性［HRFQ(-) & FOBT(+)］者更愿意接受结肠镜检查（OR=10.31，95%CI：5.22~20.13）和无痛结肠镜检查（OR=8.83，95%CI：4.28~18.23），问卷及FOBT均为阳性［HRFQ(+) & FOBT(+)］者更愿意接受结肠镜检查（OR=14.69，95%CI：11.21~19.49）、常规结肠镜检查（OR=2.29，95%CI：15.97~33.68）和无痛结肠镜检查（OR=6.64，95%CI：4.53~9.72）。［结论］ 江苏省社区结直肠癌高危人群结肠镜检查参与率较低。性别、教育水平和高危判定依据是结肠镜检查依从性的重要影响因素。大力推广无痛结肠镜，加强对女性、学历较低者以及高危判定依据为仅问卷阳性者的健康教育和初筛后的跟踪随访，有利于提升结肠镜检查依从性。 |
| 英文摘要: |
| Abstract：［Purpose］ To assess the compliance rate of colonoscopy and related factors among high-risk population undergoing colorectal cancer(CRC) screening in Jiangsu Province. ［Methods］ From October 2020 to July 2021， 3 154 residents of the Jiangsu CRC Screening Program were evaluated as high-risk for CRC. Chi-square test was used for comparing the differences of characteristics between groups. Multivariate Logistic regression model was used for analyzing the factors related to compliance rate of colonoscopy. ［Results］ Among 3 154 high-risk participants 628(19.91%) underwent colonoscopy， 212 chose painless colonoscopy， 412 chose conventional colonoscopy and information was missing in 4 subjects on the colonoscopy method choice. The leading reason for rejecting colonoscopy was fear of discomfort. Compared with subjects who rejected colonoscopy， the subjects who accepted colonoscopy tended to be male， people with higher education level and people with positive high risk factor questionnaire assessment and positive fecal occult blood test ［HRFQ(+) & FOBT(+)］(P<0.05). The multivariate logistic regression analysis showed that compared with females， males were more willing to accept colonoscopy(OR=1.57， 95%CI：1.27~1.94) and conventional colonoscopy(OR=1.65， 95%CI：1.26~2.16)； compared with illiteracy， subjects with college degree or above were more willing to accept colonoscopy(OR=1.93， 95%CI：1.08~3.40)； compared with group HRFQ(+) & FOBT(-)， group HRFQ(-) & FOBT(+) was more willing to accept colonoscopy(OR=10.31， 95%CI：5.22~20.13) and painless colonoscopy(OR=8.83， 95%CI：4.28~18.23)， and group HRFQ(+) & FOBT(+) was more willing to accept colonoscopy(OR=14.69， 95%CI：11.21~19.49)， conventional colonoscopy(OR=2.29， 95%CI：15.97~33.68) and painless colonoscopy(OR=6.64， 95%CI：4.53~9.72). ［Conclusion］ The compliance rate of colonoscopy among high-risk population in Jiangsu Province is relatively low， gender， education level and primary screening result may affect colonoscopy compliance. The colonoscopy compliance rate should be improved with necessary measures according to the influencing factors in the high-risk population. |
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