消化道肿瘤联合筛查胃肠镜依从性影响因素分析
Analysis of Endoscopic Screening Compliance and Associated Factors
投稿时间:2024-06-03  修订日期:2024-07-21
DOI:
中文关键词:  消化道肿瘤  筛查  内镜  依从性  影响因素
英文关键词:Gastrointestinal cancer  Screening  Endoscopy  Compliance  Risk factors
基金项目:中国博士后科学基金
作者单位邮编
余炜燕 南京医科大学公共卫生学院浙江省肿瘤医院 310022
李雪 浙江省肿瘤医院 
朱娟 浙江省肿瘤医院 
王晓亮 宁波市奉化区人民医院 
李寿俊 宁波市奉化区卫生健康局 
杜灵彬 浙江省肿瘤医院 
程向东* 南京医科大学公共卫生学院浙江省肿瘤医院 310022
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中文摘要:
      [目的] 探究消化道肿瘤胃肠镜筛查依从性及其影响因素,为消化道肿瘤筛查实践提供证据支持和管理建议。[方法] 基于2023年宁波市奉化区消化道肿瘤联合筛查项目,对目标人群进行消化道肿瘤风险评估,动员评估阳性人群进行胃肠镜临床筛查。采用χ2检验比较不同特征人群的消化道肿瘤风险评估阳性率和临床筛查依从率,多因素 logistic回归模型分析评估阳性人群胃肠镜临床筛查依从性的影响因素。[结果] 最终纳入分析对象共48,587人,平均年龄为63.95±7.48岁,其中男性占39.45%(19,166人)。上消化道癌和结直肠癌风险评估阳性率分别为39.00%(18,949人)和16.02%(7,782人)。胃镜和肠镜依从率分别为59.51%(11,227人)和50.85%(3,957人)。多因素logistic回归分析显示:未婚、评估日期间隔超过14天者胃镜依从性低(P<0.05);BMI ≥ 24 kg/m2、有胃肠道症状、上消化道疾病史、恶性肿瘤家族史、胃镜史、新鲜蔬菜水果摄入较少、加工肉类摄入较多的上消化道癌评估阳性人群胃镜依从性高(P<0.05)。受教育程度高、评估日期间隔超过14天者肠镜依从性低(P<0.05);有胃肠道症状,上消化道疾病史、加工肉类和油炸或烧烤食品摄入较多、上消化道癌风险评估为阳性的结直肠癌阳性人群肠镜依从性高(P<0.05)。[结论] 消化道肿瘤联合筛查受试者临床筛查胃肠镜依从性高,胃肠镜依从性与个体生活方式、健康状况、疾病史、医疗史、肿瘤家族史等因素有关。
英文摘要:
      Abstract: [Purpose] To investigate the compliance and associated factors of gastroscopy and colonoscopy screenings among high-risk populations for gastrointestinal cancers, providing evidence and management recommendations for gastrointestinal cancer screening practices. [Methods] Based on the gastrointestinal cancer screening program in Fenghua District, Ningbo, in 2023, the target population underwent risk assessment, following which high-risk individuals were mobilized for gastroscopy and colonoscopy screening. The chi-square (χ2) test was used to compare the positive rates of gastrointestinal cancer risk assessments and compliance rates of clinical screenings among populations with different characteristics. Multivariable logistic regression models were applied to analyze the factors associated with compliance rate of clinical gastroscopy and colonoscopy screenings among high-risk individuals. [Results] A total of 48,587 individuals were included in the analysis, with an average age of 63.95±7.48 years. Among them, 39.45% (19,166 individuals) were male. The positive rates of risk assessment for upper gastrointestinal cancer and colorectal cancer were 39.00%% (18,949 individuals) and 16.02% (7,782 individuals), respectively. The compliance rates for gastroscopy and colonoscopy were 59.51% (11,227 individuals) and 50.85% (3,957 individuals), respectively. Multivariable logistic regression analysis revealed that unmarried individuals and those with an assessment interval of more than 14 days had lower compliance with gastroscopy (P<0.05). High-risk individuals of upper gastrointestinal cancer with BMI ≥ 24 kg/m2, gastrointestinal symptoms, a history of upper gastrointestinal diseases, a family history of malignancy, a history of gastroscopy, less intake of fresh vegetables and fruits, and more intake of processed meats had higher compliance with gastroscopy (P<0.05). High educational levels and an assessment interval of more than 14 days were associated with lower compliance of colonoscopy (P<0.05). Among individuals with high-risk of colorectal cancer, participants with gastrointestinal symptoms, a history of upper gastrointestinal diseases, more intake of processed meats and fried or grilled foods, and a positive risk assessment for upper gastrointestinal cancer had higher compliance with colonoscopy (P<0.05). [Conclusion] Participants in the joint gastrointestinal cancer screening exhibited high compliance with both gastroscopy and colonoscopy. Compliance with gastroscopy and colonoscopy is associated with individual lifestyle, health conditions, disease history, medical history, and family history of cancers.
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