| 徐 红,万亚男,缪伟刚,等.2007—2024年江苏省淮河流域肝癌早诊早治项目筛查结果[J].中国肿瘤,2026,35(10):754-760. |
| 2007—2024年江苏省淮河流域肝癌早诊早治项目筛查结果 |
| Screening Outcomes of the Huaihe River Basin Liver Cancer Early Diagnosis and Treatment Program in Jiangsu Province from 2007 to 2024 |
| 投稿时间：2026-05-11 |
| DOI：10.11735/j.issn.1004-0242.2026.10.A002 |
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| 中文关键词: 肝癌 筛查 早诊早治 淮河流域 江苏 |
| 英文关键词:liver cancer screening early diagnosis and treatment Huaihe River Basin Jiangsu |
| 基金项目:癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项（2024ZD0524003） |
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| 中文摘要: |
| 摘 要：［目的］ 分析2007—2024年江苏省淮河流域肝癌早诊早治项目的筛查结果，评估项目在肝癌高发区人群中的实施效果。［方法］ 基于淮河流域肝癌早诊早治项目数据，纳入2007—2024年江苏省项目地区参与筛查的35～74岁常住居民作为研究对象。采用问卷调查、体格检查和乙肝表面抗原（hepatitis B virus surface antigen，HBsAg）检测的方式进行肝癌风险评估。高风险人群接受腹部B超和甲胎蛋白联合筛查。分别基于筛查人次数和筛查人数分析高风险率、筛查依从率、肝癌检出率、早诊率等指标，组间比较采用χ2检验，趋势分析采用Cochran-Armitage检验。［结果］ 2007—2024年，项目共纳入分析282 861人（351 985人次）。基于人次统计，高风险率为33.30%（117 214/351 985），筛查依从率为72.59%（85 086/117 214），共检出肝癌583例，可疑肝癌555例，肝癌检出率为0.69%，早期肝癌比例为65.18%（380/583）。男性高风险率及肝癌检出率均高于女性（P均＜0.001），但筛查依从率低于女性（P＜0.001）。HBsAg阳性人群肝癌检出率（0.90%）显著高于阴性人群（0.08%）（χ2=259.072，P＜0.001）。年龄越大，高风险率、筛查依从率和肝癌检出率越高。不同时期比较，筛查依从率从2007—2010年的29.83%升至2021—2024年的94.94%（Z=194.3，P＜0.001）。基于人数统计，高风险率为28.16%（79 667/282 861），筛查依从率为59.33%（47 267/79 667），共检出肝癌315例，可疑肝癌288例，肝癌检出率为0.67%。随着个体参与筛查次数的增加，筛查依从率呈上升趋势，参与4次及以上人群的筛查依从率均超过90%。［结论］ 江苏省淮河流域肝癌早诊早治项目持续运行18年，确诊了数百例肝癌患者，早期比例高于因症就诊人群，其公共卫生价值已逐步显现。男性、高龄及HBsAg阳性人群是肝癌筛查的重点关注对象。建议持续加强癌症防治知识普及，推动高危人群形成规律性、自主性筛查行为。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the screening outcomes of the Huaihe River Basin Liver Cancer Early Diagnosis and Treatment Program in Jiangsu Province from 2007 to 2024， and to evaluate its implementation effectiveness among populations in high-incidence areas. ［Methods］ Based on program data， permanent residents aged 35-74 years old who participated in screening in Jiangsu project areas from 2007 to 2024 were enrolled. Liver cancer risk was assessed using questionnaires， physical examinations， and hepatitis B surface antigen (HBsAg) testing. High-risk indivi-duals received combined screening with abdominal ultrasonography and alpha-fetoprotein (AFP) testing. Indicators including high-risk rate， screening compliance rate， detection rate， and early diagnosis rate were analyzed based on both person-times and person-counts. Intergroup comparisons used the Chi-square test， and trend analysis used the Cochran-Armitage test. ［Results］ From 2007 to 2024， a total of 282 861 individuals (351 985 person-times) were included. Based on person-times， the high-risk rate was 33.30% (117 214/351 985)， and the screening compliance rate was 72.59% (85 086/117 214). A total of 583 liver cancer cases and 555 suspected cases were detected， with a detection rate of 0.69%， and early-stage cases accounted for 65.18% (380/583). Males had significantly higher high-risk and detection rates but lower compliance rate than females (all P<0.001). The detection rate among HBsAg-positive individuals (0.90%) was significantly higher than that among HBsAg-negative individuals (0.08%)， representing an approximately 10.83-fold difference (χ2=259.072， P<0.001). Higher age was associated with increased high-risk， compliance， and detection rates. Over time， the compliance rate increased from 29.83% during 2007—2010 to 94.94% during 2021—2024 (Z=194.3， P<0.001). Based on person-counts， the high-risk rate was 28.16% (79 667/282 861)， the compliance rate was 59.33% (47 267/79 667)， and 315 liver cancer cases and 288 suspected cases were detected (detection rate was 0.67%). With increasing number of screening participations， the compliance rate rose progressively； among those with ≥4 participations， the compliance rate exceeded 90%. ［Conclusion］ After 18 years of continuous operation， the program has confirmed hundreds of liver cancer cases， with a higher proportion of early-stage cases than that among symptom-prompted patients， and its public health value is gradually emerging. Males， older adults， and HBsAg-positive individuals are key target populations. We recommend continued strengthening of cancer awareness education to promote regular， voluntary screening behaviors among high-risk groups. |
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