上海市嘉定区居民结直肠癌2次筛查的依从性分析

Compliance of residents with repeated screening for colorectal cancer in Jiading District, Shanghai

  • 摘要:
    目的 探索上海市嘉定区居民结直肠癌2次筛查依从性及相关因素,为嘉定区结直肠癌防控提供科学依据。
    方法 依托嘉定区自然人群队列,根据研究对象2017—2019、2020—2022年筛查情况分为从不参加筛查和参加筛查,其中参加筛查又分为参加1轮筛查和重复筛查。应用SPSS 21.0软件分析各组的人口学特征,采用χ2检验或Fisher精确概率法对性别、年龄、文化程度、婚姻状况、退休状况、医疗保险类型等因素进行单因素分析。选取P<0.05的因素纳入多因素分析,采用多因素logistic回归分析重复筛查依从性的相关因素。
    结果 纳入研究对象8 179人。其中男性3 323人、占40.6%,女性4 856人、占59.4%;平均年龄(61.26±6.06)岁;文化程度小学及以下者2 652人(32.4%),中学4 242人(51.9%),中学以上1 285人(15.7%);大多数人为在婚状态,有7 579人(92.7%)。4 062人从未参加过筛查,4 117人参加过筛查,其中1 485人重复筛查、重复筛查率18.2%。多因素logistic回归分析结果显示相较于男性,女性重复筛查依从性较好(OR=1.31,95%CI:1.14~1.50);与50~54岁的人群相比,年龄55~59岁(OR=1.57,95%CI:1.19~2.08)、60~64岁(OR=2.77,95%CI:2.13~3.61)、65~69岁(OR=3.31,95%CI:2.51~4.36)人群重复筛查依从性更高;与职工医疗保险的居民相比,居民医疗保险人群的重复筛查依从性更差(OR=0.76,95%CI:0.66~0.87);与无肠息肉史的人群相比,有肠息肉史的人群更有可能进行重复筛查(OR=2.07,95%CI:1.50~2.87)。
    结论 结直肠癌重复筛查依从性仍有待提高,不同特征人群的重复筛查依从性存在差异,识别社区结直肠癌筛查依从性不高的群体,有针对性地采取干预措施,有助于提高居民对结直肠癌筛查的持续依从性。

     

    Abstract:
    Objective To explore the compliance related factors of repeated screening for colorectal cancer in Jiading District, and to provide a scientific basis for the prevention and control of colorectal cancer.
    Methods Based on the natural population cohort in Jiading District, and the screening situation in 2017‒2019 and 2020‒2022, the study subjects were divided into the groups of never participating in screening and participating in screening. Subjects in the participating group were further divided into participating in one round of screening or having repeated screening. SPSS 21.0 software was used to analyze the demographic characteristics of each group. χ2 test or Fisher precise probability test were used to conduct univariate analysis of the factors such as gender, age, education level, marital status, retirement status, and type of medical insurance. Factors withthesignificant differenceP<0.05) were selected for inclusion in multivariate analysis, and factors related to compliance with repeated screening were analyzed by multivariate logistic regression.
    Results A total of 8 179 subjects were included in the study, including 3 323 males (40.6%) and 4 856 females (59.4%). The average age of the subjects was (61.26±6.06) years old. A total of 2 652 (32.4%) had educated in primary school or below, 4 242 (51.9%) in secondary school, and 1 285 (15.7%) in higher secondary school. Mostly, 7 579 (92.7%) were married. Among the participants, 4 062 people had never participated in screening, 4 117 people had participated in screening, and 1 485 of them had repeated screening, with a repeated screening rate of 18.2%. Multivariate logistic regression analysis showed that women had better compliance with repeated screening than men (OR=1.31, 95%CI: 1.14‒1.50). Compared with the population aged 50 to 54 years, the population aged 55‒59 years (OR=1.57, 95%CI: 1.19‒2.08), 60-64 years (OR=2.77, 95%CI: 2.13‒3.61), and 65-69 years (OR=3.31, 95%CI: 2.51‒4.36) had higher compliance with repeated screening. Compared with employees' medical insurance, residents' medical insurance group had worse compliance with repeated screening (OR=0.76, 95%CI: 0.66‒0.87). People with a history of intestinal polyps were more likely to undergo repeat screening than those without (OR=2.07, 95%CI: 1.50‒2.87).
    Conclusion Compliance with repeated screening for colorectal cancer still needs to be improved, and there are differences in compliance with repeated screening for different populations with different characteristics. Identifying groups that are unlikely to adhere to community-based colorectal cancer screening and taking targeted interventions can help improve the continued compliance of residents with colorectal cancer screening.

     

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