| 朱云峰,陆恩宁,高田静,等.浙江省海宁市两轮40~74岁目标人群结直肠癌筛查结果对比研究[J].中国肿瘤,2024,33(4):277-286. |
| 浙江省海宁市两轮40~74岁目标人群结直肠癌筛查结果对比研究 |
| Comparison of Two Rounds of Colorectal Cancer Screening Results in Target Population Aged 40~74 Years Old in Haining City of Zhejiang Province |
| 投稿时间：2023-12-14 |
| DOI：10.11735/j.issn.1004-0242.2024.04.A004 |
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| 中文关键词: 结直肠癌 40~74岁目标人群 重复筛查 对比研究 浙江 |
| 英文关键词:colorectal cancer target population aged 40~74 years old repeat screening comparative study Zhejiang |
| 基金项目:浙江省医药卫生科技计划项目（2024KY460)；海宁市科技计划项目(2022032) |
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| 中文摘要: |
| 摘 要：［目的］ 对比海宁市两轮40~74岁目标人群结直肠癌筛查结果。［方法］ 以2007—2020年期间浙江省海宁市已完成两轮结直肠癌筛查的40~74岁目标人群为研究对象，比较第一轮（2007—2012年）和第二轮（2013—2020年）的初筛阳性率、结肠镜依从率、息肉及以上病变（息肉、腺瘤、癌）检出率、阳性病例检出率和早诊率等。［结果］ 第二轮目标人群初筛高危率（14.93%）高于第一轮（13.82%）（P<0.001）；第二轮息肉及以上病变检出率（33.92%）高于第一轮（25.78%）（P<0.001）；第二轮阳性病例检出率（8.64%）高于第一轮（6.34%）（P<0.001）；第二轮早诊率（97.58%）高于第一轮（96.77%）（P=0.099）。两轮各年龄组阳性病例检出率总体随年龄增长而上升，其中第一轮65~69岁年龄组检出率最高（10.11%），第二轮70~74岁年龄组检出率最高（12.35%），第二轮各年龄组检出率均大于第一轮，除65~69岁差异无统计学意义外，其余各年龄组差异均有统计学意义（P均<0.05）；两轮阳性病例检出率均为男性大于女性，且不同性别检出率第二轮均大于第一轮（P<0.001）。在两轮相同目标人群中，第二轮初筛高危率为13.96%，高于第一轮的13.33%（P<0.001）；第二轮结肠镜依从率为85.00%，高于第一轮的75.85%（P<0.001）；第二轮息肉及以上病变检出率为34.93%，高于第一轮的26.47%（P<0.001）；第二轮阳性病例检出率为9.05%，高于第一轮的5.84%（P<0.001）。［结论］ 对比海宁市两轮结直肠癌筛查结果，间隔5年以上持续重复开展结直肠癌筛查成效显著，各地应结合当地实际情况，合理确定重复筛查间隔时间和起始年龄，以达到最佳筛查效果。 |
| 英文摘要: |
| Abstract：［Purpose］ To compare the results of two rounds of colorectal cancer screening in the target population aged 40~74 years old in Haining City. ［Methods］ Colorectal cancer screening was conducted among the target population aged 40~74 years old in Haining City of Zhejiang Province from 2007 to 2020. The screening results， including the initial screening positivity rate， colonoscopy adherence rate， polyp and above lesion detection rate， positive detection rate， and early diagnosis rate were compared between the first round (2007—2012) and the second round (2013—2020). ［Results］ The high risk rate in initial screening of the second round was higher than that in the first round (14.93% vs 13.82%， P<0.001)； the detection rate of polyps and above lesions in the second round was higher than that in the first round (33.92% vs 25.78%， P<0.001)； the detection rate of positive cases in the second round was higher than that in the first round (8.64% vs 6.34%， P<0.001)； and the diagnosis rate of early cancer in the second round was higher than that of the first round (97.58% vs 96.77%， P=0.099). The detection rate of positive cases increased with age， with the highest detection rate in the age group of 65~69 years old (10.11%) for the first round， and 70~74 years old (12.35%) for the second round， and the detection rate was higher in all age groups of the second round than that in the first round (all P<0.05， except for age group of 65~69 years old)； the detection rate of positive cases in both rounds was higher in males than that in females (P<0.001). In the same target population of two rounds， the high risk rate of initial screening in the second round was higher than that in the first round (13.96% vs 13.33%， P<0.001)； the compliance rate of colonoscopy in the second round was higher than that in the first round (85.00% vs 75.85%， P<0.001)； the detection rate of polyps and above lesions in the second round was higher than that in the first round (34.93% vs 26.47%， P<0.001)； the detection rate of positive cases in the second round was higher than that in the first round (9.05% vs 5.84%， P<0.001). ［Conclusion］ Comparing the results of two rounds of colorectal cancer screening in Haining City， the effectiveness of repeating colorectal cancer screening at intervals of >5 years is remarkable. To achieve the best screening effect， the screening location， the interval time and starting age should be under consideration. |
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