| 肖 露,赵胜林,于智凯,等.2013—2021年重庆市肺癌高危人群筛查依从性及其影响因素分析[J].中国肿瘤,2025,34(3):203-208. |
| 2013—2021年重庆市肺癌高危人群筛查依从性及其影响因素分析 |
| Analysis of Lung Cancer Screening Compliance Among High-Risk Population in Chongqing from 2013 to 2021 |
| 投稿时间：2024-03-01 |
| DOI：10.11735/j.issn.1004-0242.2025.03.A006 |
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| 中文关键词: 肺癌 筛查 依从性 低剂量螺旋CT 重庆 |
| 英文关键词:lung cancer screening compliance rate low-dose computed tomography Chongqing |
| 基金项目:重庆市首批公共卫生重点学科（专科）（渝卫办发[2022]72号） |
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| 中文摘要: |
| 摘 要： ［目的］ 分析2013—2021年重庆市城市癌症早诊早治项目肺癌高危人群参与低剂量螺旋CT（low-dose computed tomography，LDCT）筛查依从性及其影响因素分析。［方法］ 采用整群抽样方法，选取来自重庆市14个城区的常住居民进行问卷调查以评估癌症风险，对评估出的肺癌高危人群进行LDCT筛查。计算肺癌高危人群接受肺癌筛查的依从性，采用χ2检验比较不同特征社区居民肺癌筛查依从性的差异。采用广义线性混合模型分析肺癌高危人群筛查依从性的影响因素。［结果］ 完成风险评估问卷的社区居民共316 066人，其中52 858人评估为高危，高危率为17.17%。高危人群中完成LDCT筛查20 398人，总体筛查依从率为38.59%。广义线性混合模型结果显示，男性（OR=0.871，95%CI=0.823~0.922）、轻度吸烟（OR=0.829，95%CI：0.775~0.886）与重度吸烟（OR=0.842，95%CI：0.792~0.896）人群的依从性更低。受教育程度高（OR=1.347，95%CI：1.265~1.435）、职业接触有害物质（OR=1.400，95%CI：1.340~1.463）、被动吸烟20年及以上（OR=1.472，95%CI：1.376~1.576）、不经常参加体育锻炼（OR=1.203，95%CI：1.152~1.256）、有肺癌家族史（OR=2.312，95%CI：2.201~2.429）、社区工作人员使用媒体宣传（OR=1.365，95%CI：1.223~1.524）、社区工作人员经过培训（OR=1.343，95%CI：1.227~1.470）的依从性更高；基线共病也是影响筛查依从性的因素，并且随着基线共病数量的增加，高危人群参与LDCT筛查的依从率呈增长趋势（P<0.001）。［结论］ 重庆市LDCT筛查依从性有待提高。未来应针对不同特征人群实施更加精准的健康教育，以期提高肺癌高危人群的LDCT筛查依从性。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the compliance and its influencing factors of lung cancer screening using low-dose computed tomography(LDCT) among high-risk population in urban districts of Chongqing from 2013 to 2021. ［Methods］ The lung cancer screeing of Cancer Early Diagnosis and Treatment Project was conducted among permanent residents aged 40～69 years old from 14 urban districts of Chongqing selected by cluster sampling method from 2013 to 2021. The questionnaire survey was performed to assess the risk level of lung cancer， and individuals with high risk were advised to have LDCT examination. The compliance rate of LDCT examination among high-risk populations was calculated and compared using Chi-square test among residents with different demographic features; the influencing factors of compliance was analyzed with generalized linear mixed models. ［Results］ A total of 316 066 residents completed the risk assessment questionnaire survey， 52 858 people were assessed as high-risk (17.17%). Among the high-risk population， 20 398 completed LDCT screening， with an overall compliance rate of 38.59%. The generalized linear mixed model showed that male participants (OR=0.871， 95%CI：0.823~0.922) and smokers (light smokers： OR=0.829， 95%CI： 0.775~0.886; heavy smokers： OR=0.842， 95%CI： 0.792~0.896) had lower compliance rates; while people with higher education level (OR=1.347， 95%CI： 1.265~1.435)， occupational exposure to harmful substances (OR=1.400， 95%CI： 1.340~1.463)， passive smoking for 20 years or more (OR=1.472， 95%CI： 1.376~1.576)， infrequent physical exercise (OR=1.203， 95%CI： 1.152~1.256)， family history of lung cancer (OR=2.312， 95%CI： 2.201~2.429)， and those having media promotion by community staff (OR=1.365， 95%CI： 1.223~1.524)， and trained community staff (OR=1.343， 95%CI： 1.227~1.470) had higher compliance rates. Comorbidities were also factors influencing compliance， and there was an increasing trend of compliance rate with the increase of comorbidity numbers(P<0.001). ［Conclusion］ The compliance rate of LDCT examination for lung cancer screening in Chongqing needs to be improved， and more precise health education should be implemented for groups with different characteristics to improve the compliance among high-risk population. |
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