摘要
[目的]分析40~74岁不同年龄段人群结直肠癌筛查情况及肠镜检查结局,为调整结直肠癌筛查起始年龄提供科学依据和参考。[方法]收集、整理2015—2018年广州市40~74岁试点结直肠癌筛查数据,评价和比较40~74岁不同年龄段人群高危因素问卷调查(high-risk factor questionnaire,HRFQ)、粪便隐血试验(fecal occult blood test,FOBT)和全结肠镜检查的筛查效果。[结果]47176人参与了筛查,初筛阳性10608人,初筛阳性率22.49%;40~44岁、45~49岁、50~54岁和55~74岁年龄组初筛阳性率分别为21.91%(365/1666)、20.87%(569/2727)、20.80%(1279/6149)和22.92%(8395/36634),差异有统计学意义(P<0.001),其中女性55~74岁年龄组初筛阳性率22.58%(5025/22255)高于其他年龄组(P<0.001)。男、女性FOBT参与率高年龄组高于40~44岁和45~49岁年龄组(P<0.001)。初筛阳性者中,2867人参与了肠镜检查,肠镜检查依从率27.03%(2867/10608),其中40~44岁(31.23%)、45~49岁(30.76%)和50~54岁年龄组(34.09%)肠镜检查依从率高于55~74岁年龄组(25.52%)(P<0.001)。肠镜下发现肠道病变1399例,总体病变检出率48.80%,非进展性腺瘤、进展性腺瘤、结直肠癌检出率分别为15.84%(454/2867)、12.56%(360/2867)和2.27%(65/2867)。不同年龄组肠道病变、非进展性腺瘤、进展性腺瘤检出率存在差异,男女性均随着年龄增加,肠道病变、非进展性腺瘤、进展性腺瘤检出率增加;45~49岁年龄组中非进展性腺瘤构成比较高,为61.8%;55~74岁年龄组肠癌检出构成比较高,为8.1%,但各年龄组差异无统计学意义(χ^(2)=5.574,P=0.473)。[结论]广州市普通人群40~44岁、45~49岁与50~74岁年龄组人群有相似的结直肠癌发病风险,40~54岁肠镜检查顺应性较好,肠道病变中轻症构成较高。在对普通人群开展结直肠癌筛查中,可以考虑将筛查起始年龄提前至40岁或者45岁,以获得更好的社会和经济效益。
[Purpose]To analyze colorectal cancer screening in population aged 40~74 years in Guangzhou pilot communities.[Methods]Data of pilot screening of colorectal cancer among community-dwelling residents in Guangzhou from 2015 to 2018 were collected.The results of high-risk factor questionnaire(HRFQ)survey,the positive rate of fecal occult blood test(FOBT)and the detection rate of colonoscopy were evaluated.[Results]There were 47176 residents aged 40~74years participating in the screening and 10608 cases(22.49%)were identified as high risk by HRFQ.The positive rates of primary screening at age groups of 40~44,45~49,50~54 and 55~74years were 21.91%(365/1666),20.87%(569/2727),20.80%(1279/6149)and 22.92%(8395/36634),respectively(P<0.001).The positive rate of primary screening in women aged 55~74years was higher than that in other age groups[22.58%(5025/22255),P<0.001].The participation rate of age group of 55~74 years for FOBT test was higher than that at the 40~49 age groups(P<0.001).Colonoscopies were performed on 2867 high risk cases(27.03%).The compliance rate of colonoscopy at age groups of 40~44 years(31.23%),45~49 years(30.76%)and 50~54 years(34.09%)was higher than that at age group of 55~74 years(25.52%)(P<0.001).Intestinal lesions were found in 1399 cases(48.8%).The detection rates of non-progressive adenoma,progressive adenoma and colorectal cancer were 15.84%(454/2867),12.56%(360/2867)and 2.27%(65/2867),respectively.There were significant differences in the detection rates of intestinal lesions,nonprogressive adenoma and progressive adenoma among different age groups.The detection rates of intestinal lesions,non-progressive adenoma and progressive adenoma increased with age in both men and women.The proportion of non-progressive adenoma at 45~49 age group was higher(61.8%)The proportion of colorectal cancer detected at 55~74 age group was 8.1%,but there was no significant difference in detection rate of colorectal cancer among different groups(χ^(2)=5.574,P=0.473).[Conclusion]In the general population of Guangzhou,the risk of colorectal cancer was similar at age groups of 40~44,45~49 and 50~74 years.The compliance of colonoscopy was better at 40~54 age group,and mild intestinal lesions accounted for a higher proportion.The screening of colorectal cancer in general population may start from age of 40 or 45 years for better social and economic benefits.
作者
李科
梁颖茹
秦鹏哲
梁伯衡
李燕
LI Ke;LIANG Ying-ru;QIN Peng-zhe;LIANG Bo-heng;LI Yan(Guangzhou Center for Disease Control and Prevention,Guangzhou 510440,China)
出处
《中国肿瘤》
CAS
CSCD
北大核心
2023年第1期39-45,共7页
China Cancer
关键词
结直肠癌
筛查
年龄
广东
colorectal cancer
screening
age
Guangdong
作者简介
通信作者:李燕,E-mail:710146599@qq.com
