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2014 — 2017年北京市城市结直肠癌早诊早治项目筛查结果分析

Effectiveness of colorectal cancer screening among urban populations in Beijing, 2014 – 2017

  • 摘要:
      目的  评估北京市2014 — 2017年城市结直肠癌早诊早治筛查结果,为探索适宜城市地区结直肠癌筛查的管理模式提供参考依据。
      方法  根据国家城市癌症早诊早治项目方案要求,北京市采用整群抽样方法于城6区(东城、西城、朝阳、海淀、丰台和石景山区)纳入40~69岁健康人群参与癌症筛查高危风险问卷评估,对评估出的结直肠癌高危人群进行临床肠镜筛查,并对肠镜检查发现的病变及时治疗,计算结直肠癌高危评估率、临床筛查依从率以及筛查病变检出率。
      结果  63 032名北京市40~69岁健康居民纳入风险评估,评估出结直肠癌高危人群11 000人,高危率为17.45 %,其中男性4 125人,女性6 875人;完成肠镜检查2 843人,依从率为25.85 %,其中男性1 039人,女性1 804人;结直肠癌、进展期腺瘤、非进展期腺瘤及息肉的检出率分别为0.49 %、5.98 % 和23.71 %。
      结论  结直肠癌筛查项目具有较高的检出率,及时治疗早期病变可以取得较好的效果;应努力提高依从性,建立社区及二三级医院综合筛查体系。

     

    Abstract:
      Objective  To evaluate results of colorectal cancer (CRC) screening among urban populations in Beijing from 2014 to 2017 and to provide evidence for establishing appropriate management strategy for CRC screening.
      Methods  Accord-ing to the protocal of the program of cancer screening in urban China, we conducted cluster sampling surveys among 40 – 69 years old residents in six urban districts of Beijing from 2014 to 2017. A questionnaire risk assessment was administered to all the participants and colonoscopy was performed in the individuals with high CRC risk to detect clinical lesions. The high risk rate, colonoscopy compliance rate and lesion detection rate were calculated for effectiveness evaluation.
      Results  Among 636 032 residents participating in the screening survey during the 4-year period, 11 000 (17.45%) were assessed with high CRC risk. Of the 4 125 male and 6 875 female participants at high CRC risk, 1 039 and 1 804 had colonoscopy, with an overall compliance rate of 25.85%. For all the colonoscopies, the detection rates of CRC, advanced adenoma, and non-advanced adenoma/polyps were 0.49%, 5.98%, and 23.71%, respectively.
      Conclusion  The screening survey resulted in relatively high detection rates of CRC-related clinical lesions in early stage, but the colonoscopy compliance rate needs to be increased.

     

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