| 容敏华,余红平,葛莲英,等.2014—2022年广西城市癌症早诊早治项目高危评估和随访结果分析[J].中国肿瘤,2026,35(8):605-612. |
| 2014—2022年广西城市癌症早诊早治项目高危评估和随访结果分析 |
| Analysis of High-Risk Assessment and Follow-Up Results of the Guangxi Urban Cancer Screening Project from 2014 to 2022 |
| 投稿时间：2026-05-26 |
| DOI：10.11735/j.issn.1004-0242.2026.08.A004 |
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| 中文关键词: 癌症 高危评估 随访 城市地区 广西 |
| 英文关键词:cancer high-risk assessment follow-up urban areas Guangxi |
| 基金项目:2022年度广西高校中青年教师科研基础能力提升项目（2022KY0092） |
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| 中文摘要: |
| 摘 要：［目的］ 分析广西壮族自治区2014—2022年城市癌症早诊早治项目人群的癌症高风险评估和随访结果，为评价区域项目实施效果和癌症早诊早治策略提供依据。［方法］ 2014年11月至2022年12月，按照《城市癌症早诊早治项目技术方案》对广西南宁市、梧州市、柳州市辖区40～74岁城市居民开展五大类癌症（肺癌、结直肠癌、上消化道癌、乳腺癌和肝癌）危险因素问卷调查和高危人群评估。对队列人群进行主动和被动随访，与所在地肿瘤登记数据库和全人口死因监测数据库进行匹配，随访时间截至2024年3月，获得队列人群中以上五大类癌症的发病信息。以年龄、性别、评估年度、综合至少一项或单项高危等因素进行分层，比较队列各种特征人群五大类高发癌症的高危率和发病情况，计算发病风险比（hazard ratio，HR）及其95%置信区间（confidence interval，CI）。［结果］ 完成防癌风险问卷评估共200 583人，40～49岁年龄组居多，占比33.50%；女性占比56.67%；至少一项癌种高危率为71.31%，单项高危率最高的是女性乳腺癌（33.21%），其次为肺癌（25.48%）、肝癌（24.47%）；不同性别、年龄组和评估年度人群的高危率差异有统计学意义（P均<0.001）。共计随访1 310 805.40人年，人均随访（6.54±2.18）年，确诊癌症2 634例，累积发病率为1 313.17/10万，发病密度为200.95/10万人年。男性五癌发生风险高于女性，发病风险HR（95%CI）为1.113（1.018~1.217）；70~74岁组相比较于40~49岁组，HR（95%CI）为3.581（2.998~4.278）；至少一项癌症高危者癌症发生风险高于非高危者，HR（95%CI）为1.154（1.041~1.278）；单项乳腺癌、结直肠癌和肺癌高危的人群相比较于同癌种非高危人群，发病风险分别为1.930（1.564~2.381）、1.296（1.062~1.582）和1.285（1.100~1.502）；单项肝癌、胃癌、食管癌高危人群相比同癌种非高危人群，癌症发病风险没有明显差异。［结论］ 城市癌症早诊早治项目癌症高风险评估模型对本区域不同癌种高危人群的识别能力不同，加入生物标志物检测等优化项目评估方案后可进一步浓缩高危人群。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the cancer high-risk assessment and follow-up results of the urban cancer early detection and treatment project population in Guangxi Zhuang Autonomous Region from 2014 to 2022， providing a basis for evaluating the implementation effect of regional projects and cancer early detection and treatment strategies. ［Methods］ From November 2014 to December 2022， according to the “Technical Plan for the Urban Cancer Early Detection and Treatment Project”， a cancer risk factor questionnaire survey on risk factors and assessments of high-risk populations for five major types of cancer (lung cancer， colorectal cancer， upper gastrointestinal cancer， breast cancer， and liver cancer) were conducted among urban residents aged 40 to 74 years old in Nanning， Wuzhou， and Liuzhou， Guangxi. Active and passive follow-ups were conducted on the cohort population， matched with local cancer registration databases and population-wide cause-of-death surveillance databases. The follow-up period ended in March 2024， obtaining incidence information on the above five types of cancer among the cohort population. Stratification was performed based on age， gender， assessment year， and at least one or single high-risk factor， and the high-risk rates and incidence of the five major high-incidence cancers among various characteristics of the cohort were compared. ［Results］ A total of 200 583 people completed the cancer risk questionnaire assessment， with the majority aged 40 to 49 years old， accounting for 33.50%； females accounted for 56.67%； the high-risk rate for at least one cancer type was 71.31%， with the highest single high-risk rate being female breast cancer (33.21%)， followed by lung cancer (25.48%)， and liver cancer (24.47%)； there were significant differences in high-risk rates among different sexes， age groups， and assessment years (all P<0.001). A total of 1 310 805.40 person-years were followed up， with an average follow-up of (6.54±2.18) years， and 2 634 cases of confirmed cancer were identified， with a cumulative incidence rate of 1 313.17/105 and an incidence density of 200.95/105 person-years. The risk of developing the five cancers was higher in male than that in female， with a hazard ratio (HR) ［95% confidence interval(CI)］ of 1.113 (1.018-1.217)； compared to the age group of 40-49 years old， the HR (95%CI) was 3.581(2.998-4.278) in the age group of 70-74 years old； the risk of developing cancer was higher in individuals with at least one high-risk factor for cancer than in those without， with an HR (95%CI) of 1.154 (1.041-1.278)； compared to non-high-risk individuals with the same cancer type， the HR of developing breast cancer， colorectal cancer， and lung cancer was 1.930 (1.564-2.381)， 1.296 (1.062-1.582)， and 1.285(1.100-1.502)， respectively； there was no significant difference in the risk of developing cancer between high-risk individuals with single liver cancer， gastric cancer， and esophageal cancer compared to non-high-risk individuals with the same cancer type. ［Conclusion］ The cancer high-risk assessment model of the urban cancer early detection and treatment project showed varying predictive values for identifying high-risk populations of different cancer types in this region， and the project assessment scheme could be further optimized by incorporating biomarker detection to further concentrate high-risk individuals. |
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