| 张 希,杨 雷,李晴雨,等.2017—2021年北京市农村地区居民结直肠癌筛查结果及结肠镜检查依从性分析[J].中国肿瘤,2023,32(8):603-609. |
| 2017—2021年北京市农村地区居民结直肠癌筛查结果及结肠镜检查依从性分析 |
| Analysis of Screening Results and Compliance of Colorectal Cancer Among Rural Residents in Beijing，2017 — 2021 |
| 投稿时间：2023-03-02 |
| DOI：10.11735/j.issn.1004-0242.2023.08.A006 |
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| 中文关键词: 结直肠癌 筛查 早诊早治 依从性 北京 |
| 英文关键词:colorectal cancer screening early diagnosis and treatment compliance Beijing |
| 基金项目: |
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| 中文摘要: |
| 摘 要：［目的］分析2017—2021年北京市农村地区居民结直肠癌筛查结果及结肠镜检查依从性。［方法］ 采用整群抽样的方法选取北京市9个区的农村地区的40~74岁居民参与结直肠癌筛查。采用危险因素问卷调查和免疫法粪便潜血试验（FIT）进行初筛，对评估为高危的人群进行结肠镜检查。计算结直肠癌高危率、结肠镜检查的依从性及病变检出率。采用χ2检验比较不同特征居民对结肠镜检查依从性的差异和不同年龄段居民进展期腺瘤和癌与非进展期腺瘤检出率之间的差异。采用多因素Logistic回归模型分析结直肠癌高危人群结肠镜依从率的影响因素。［结果］ 共有153 791名居民完成结直肠癌危险因素问卷评估，评估出高危人群41 401人，高危率为26.9%。24 401人进行结肠镜检查，依从率为58.9%。多因素Logistic回归模型分析结果提示，与40~44岁的人群相比，60~64岁（OR=0.89，95%CI：0.80~0.98）、65~69岁（OR=0.74，95%CI：0.67~0.81）、70~74岁（OR=0.61，95%CI：0.54~0.69）的人群更不愿意接受结肠镜检查；与小学及以下文化程度者相比，中学文化程度者（OR=1.18，95%CI：1.12~1.24）与大学及以上文化程度者（OR=1.18，95%CI：1.10~1.27）更愿意接受结肠镜检查；与不饮酒的人群相比，饮酒的人群（OR=1.10，95%CI：1.04~1.17）更愿意接受结肠镜检查；有炎症性肠病史（OR=1.20，95%CI：1.13~1.29）、肠道息肉史（OR=1.08，95%CI：1.02~1.15）、一级亲属罹患结直肠癌史（OR=1.09，95%CI：1.01~1.18）的人群更愿意接受结肠镜检查；与单独FIT检测阳性的人群相比，单独危险因素问卷阳性（OR=1.24，95%CI：1.18~1.31）和问卷与FIT均阳性（OR=1.49，95%CI：1.39~1.60）的人群更愿意接受结肠镜检查。结肠镜共检出进展期腺瘤及以上病变1 269例，检出率为5.2%。随着年龄增长，检出率递增。［结论］ 北京市农村地区结直肠癌高风险人群的结肠镜依从性仍待提升，应针对不同特征人群进行健康宣教，提高结肠镜检查覆盖率。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the results of colorectal cancer screening and the compliance of colonoscopy among residents in rural areas of Beijing from 2017 to 2021. ［Methods］ Residents aged 40~74 in rural areas of nine districts in Beijing selected by cluster sampling participated in colorectal cancer screening during 2017—2021. The questionnaire risk assessment and fecal immunochemical test(FIT) were used for primary screening， and participants with positive results of any test were referred to undergo a diagnostic colonoscopy. The rate of high-risk population for colorectal cancer， compliance rate of colonoscopy， and detection rate of colorectal lesions were calculated. Chi-square test was applied to compare the differences of screening colonoscopy participant rates between groups， as well as the difference between the detection rate of advanced adenoma and cancer and non-advanced adenoma in residents of different ages. Multivariate Logistic regression was used to analyze the influencing factors of colonoscopy compliance. ［Results］ A total of 153 791 residents in Beijing rural areas completed the questionnaire risk assessment. Among 41 401(26.9%) high-risk individuals， 24 401 underwent colonoscopy with a compliance rate of 58.9%. The multivariate Logistic regression analysis showed that compared with age group of 40~44 years old， individuals aged 60~64， 65~69 or 70~74 years old were more unwilling to receive colonoscopy examination(OR=0.89， 95%CI： 0.80~0.98； OR=0.74， 95%CI： 0.67~0.81； OR=0.61， 95%CI： 0.54~0.69， respectively)； compared to those with primary school education or below， those with junior high and high school or college education and above were more willing to receive colonoscopy(OR=1.18， 95%CI： 1.12~1.24； OR=1.18， 95%CI： 1.10~1.27)； compared with non-drinkers， drinkers(OR=1.10， 95%CI： 1.04~1.17) were more willing to accept colonoscopy； compared with individuals with no inflammatory bowel disease(IBD)， those with IBD(OR=1.20， 95%CI： 1.13~1.29) were more willing to receive colonoscopy； compared with individuals without polyp history， individuals having history of polyps(OR=1.08， 95%CI： 1.02~1.15) were more willing to accept colonoscopy； compared with individuals without CRC in their first- degree relatives， individuals with CRC in their first degree relatives(OR=1.09， 95%CI： 1.01~1.18) were more willing to receive colonoscopy； compared with only FIT positive， risk assessment positive(OR=1.24， 95%CI： 1.18~1.31) and both questionnaire and FIT positive(OR=1.49， 95%CI： 1.39~1.60) were more willing to receive colonoscopy. Total 1 269 progressive adenoma and above lesions were detected by colonoscopy with a detection rate of 5.2%； and the detection rate increased with age. ［Conclusion］ Colonoscopy screening compliance of individuals of colorectal cancer high-risk in rural areas of Beijing still needs to be improved. Efforts should be made for people with different characteristics to improve the coverage of colonoscopy. |
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