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| 浙江省兰溪市2023—2024年上消化道癌与结直肠癌联合筛查效果评价 |
| Effectiveness evaluation of combined screening for upper gastrointestinal and colorectal cancers in Lanxi, Zhejiang, 2023–2024 |
| 投稿时间：2025-12-30 修订日期：2026-02-27 |
| DOI： |
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| 中文关键词: 消化道肿瘤 癌症筛查 内镜 效果评价 兰溪市 |
| 英文关键词:Gastrointestinal neoplasms Cancer screening Endoscopy Effectiveness evaluation Lanxi City |
| 基金项目:金华市科技局重大重点科技计划项目(2023-3-009)；金华市中医药科技计划重大重点项目(2024ZD03) |
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| 摘要点击次数: 46 |
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| 中文摘要: |
| 目的：上消化道癌和结直肠癌是我国消化道癌症的主要负担，筛查已被证明可以有效降低癌症的发病率和死亡率。然而，单一癌种筛查存在筛查率低、资源利用不足等问题。本研究基于兰溪市的多癌筛查项目，评价其短期内在癌症筛查中的效果，探索上消化道癌与结直肠癌联合筛查的可行性。方法：本研究依托浙江省兰溪市中医院开展的消化道癌症联合筛查项目，招募40-74岁居民，采用问卷调查和生物标志物检测进行高危人群筛查。符合高危标准者接受胃镜和肠镜检查，以评估癌前病变的检出率，并比较不同风险人群的筛查参与率及病变检出率。结果：共17,615名受试者完成初筛，其中7,215人（39.9%）被评估为上消化道癌高风险，4,723人（25.0%）为结直肠癌高风险，2,117人（12.0%）同时符合上消化道癌和结直肠癌的双重高风险标准，占上消化道癌高风险人群的30.7%，占结直肠癌高风险人群的45.1%。在高风险人群的筛查参与率方面，共同高风险人群的胃镜参与率为43.0%，肠镜参与率为48.6%。在癌症检出率方面，共同高风险人群的上消化道癌前病变检出率为0.6%，癌症检出率为0.6%，结直肠癌前病变的检出率为12.0%，癌症检出率为0.2%。结论：消化道癌联合筛查模式可有效识别共同高风险人群，并促进癌及癌前病变的检出，有助于推动筛查流程集成与资源优化，具有应用前景，但其效能优势仍需在设置对照组的前瞻性研究中进一步验证。 |
| 英文摘要: |
| Objective: Upper gastrointestinal cancer and colorectal cancer represent the primary burden of gastrointestinal malignancies in China. Screening has been proven effective in reducing both the incidence and mortality of these cancers. However, single-cancer screening programs often suffer from low participation rates and inefficient resource utilization. This study, based on a multi-cancer screening project in Lanxi City, aimed to evaluate the short-term effectiveness of cancer screening and to explore the feasibility of a combined screening approach for upper gastrointestinal and colorectal cancers. Methods: This study was conducted as part of a gastrointestinal cancer screening initiative led by Lanxi Hospital of Traditional Chinese Medicine in Zhejiang Province. Residents aged 40–74 years were recruited and underwent risk assessment through a standardized questionnaire and biomarker testing. Individuals identified as high-risk were referred for gastroscopy or colonoscopy to assess the detection rate of precancerous lesions. Screening participation rates and detection rates were compared across different risk groups. Results: A total of 17,615 participants completed the initial screening. Of these, 7,215 (39.9%) were classified as high-risk for upper gastrointestinal cancer, 4,723 (25.0%) as high-risk for colorectal cancer, and 2,117 (12.0%) met the criteria for high risk of both cancers. These dual high-risk individuals accounted for 30.7% of those at high risk for upper gastrointestinal cancer and 45.1% of those at high risk for colorectal cancer. Among this group, the participation rates for gastroscopy and colonoscopy were 43.0% and 48.6%, respectively. The detection rates of upper gastrointestinal precancerous lesions and cancer were 0.6% and 0.6%, respectively, while the detection rates for colorectal precancerous lesions and cancer were 12.0% and 0.2%, respectively. Conclusion: The combined screening model for gastrointestinal cancers effectively identifies individuals at dual high risk and facilitates detection of cancer and precancerous lesions. It also streamlines screening workflows and optimizes resource utilization, suggesting good potential for wider application. However, its effectiveness should be further validated in future prospective studies with appropriate control groups. |
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