郑俏俏,吴思雅,张 宁,等.中国上消化道癌高危人群内镜筛查依从率的Meta分析[J].肿瘤学杂志,2026,32(2):93-103.
中国上消化道癌高危人群内镜筛查依从率的Meta分析
Compliance Rate of Endoscopic Screening in High-Risk Population of Upper Gastrointestinal Cancer in China: a Meta-Analysis
投稿时间:2024-10-29  
DOI:10.11735/j.issn.1671-170X.2026.02.B002
中文关键词:  上消化道癌  依从率  内镜筛查  高危人群  Meta分析
英文关键词:upper gastrointestinal cancer  compliance rate  endoscopic screening  high risk population  Meta-analysis
基金项目:国家重点研发计划政府间国际科技创新合作重点专项(2021YFE0106000)
作者单位
郑俏俏 郑州大学附属肿瘤医院/河南省肿瘤医院,河南省肿瘤防控工程研究中心,河南省肿瘤预防国际联合实验室,河南省肿瘤防治办公室 郑州大学公共卫生学院 
吴思雅 郑州大学附属肿瘤医院/河南省肿瘤医院,河南省肿瘤防控工程研究中心,河南省肿瘤预防国际联合实验室,河南省肿瘤防治办公室 郑州大学公共卫生学院 
张 宁 郑州大学附属肿瘤医院/河南省肿瘤医院,河南省肿瘤防控工程研究中心,河南省肿瘤预防国际联合实验室,河南省肿瘤防治办公室 郑州大学公共卫生学院 
王博祥 郑州大学附属肿瘤医院/河南省肿瘤医院,河南省肿瘤防控工程研究中心,河南省肿瘤预防国际联合实验室,河南省肿瘤防治办公室 郑州大学公共卫生学院 
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中文摘要:
      摘 要:[目的] 分析中国基于人群的上消化道癌筛查项目中高危人群参加内镜筛查的依从率,为制定干预措施提供依据。 [方法] 系统检索英文数据库(Web of Science、PubMed和Embase)和中文数据库(中国知网、万方和维普)中有关中国人群的上消化道癌内镜筛查依从率的文献,考虑区域、年龄、性别和项目的差异进行亚组分析,并进行敏感性分析和发表偏倚的评价。[结果] 共纳入34篇文献,包含16个行政区766 039名研究对象。中国上消化道癌高危人群的内镜筛查依从率为35.8%(95%CI:31.0%~40.5%)。亚组分析显示,农村地区(44.3%)内镜筛查依从率高于城市地区(32.5%)(P<0.05);男性依从率为37.9%,女性为42.9%(P>0.05);50~59岁年龄组依从率为41.6%,40~49岁年龄组为37.5%(P>0.05);淮河流域癌症早诊早治项目的依从率高于城市癌症早诊早治项目的依从率(P<0.05)。农村地区男性依从率(41.7%)低于女性(49.4%)(P<0.05),依从率随年龄的增长而增长;城市地区50~59岁年龄组依从率为38.9%,60~74岁年龄组为30.7%,差异无统计学意义(P>0.05)。通过敏感性分析剔除样本量较小的文献之后,Meta分析的结果稍有改变。 [结论] 中国上消化道癌高危人群内镜筛查依从率较低,且存在明显的地区与性别差异,需对男性及城市地区采取针对性措施,同时提高筛查提供方的能力建设,以提高公众的筛查意识和参与度。
英文摘要:
      Abstract:[Objective] To analyze the compliance of endoscopic screening among high-risk populations for upper gastrointestinal cancer in China. [Methods] A systematic literature search was conducted in English databases (Web of Science, PubMed, and Embase) and Chinese databases (CNKI, Wanfang, and VIP) to identify studies reporting the compliance rates of endoscopic screening for upper gastrointestinal cancer among Chinese populations. Subgroup analyses were performed by region, age, gender, and screening program. Additionally, sensitivity analysis and publication bias assessment were also conducted. [Results] A total of 34 studies from 16 administrative regions, involving 766 039 participants, were included. The overall compliance rate of endoscopic screening for upper gastrointestinal cancer among high-risk populations was 35.8% (95%CI: 31.0%~40.5%). Subgroup analyses revealed that the compliance rate was higher in rural areas (44.3%) compared to urban areas (32.5%) (P<0.05). The compliance rates were 37.9% for males and 42.9% for females (P>0.05). The age group of 50~59 years old showed a compliance rate of 41.6%, while the age group of 40~49 years old showed 37.5% (P>0.05). In the Huaihe River Basin Cancer Early Detection and Treatment Project demonstrated higher compliance rates than Urban Cancer Early Diagnosis and Treatment Project (P<0.05). In rural areas, males showed lower compliance (41.7%) compared to females (49.4%) (P<0.05), with compliance rates increasing with age. In urban areas, the compliance rates were 38.9% for the age group of 50~59 years old and 30.7% for the age group of 60~74 years old(P>0.05). After excluding studies with smaller sample sizes through sensitivity analysis, there were slight changes in the meta-analysis results. [Conclusion] The study revealed suboptimal compliance rates for endoscopic screening among high-risk populations for upper gastrointestinal cancer in China, with significant regional and gender disparities, suggesting that design of targeted interventions is needed to improve compliance rate.
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