上海市嘉定镇社区居民大肠癌筛查模式的效果评价

汤伟琴; 罗纯薇; 陶琼英; 陆菊萍

doi:10.19428/j.cnki.sjpm.2018.18719

上海市嘉定镇社区居民大肠癌筛查模式的效果评价

Effect evaluation on screening modes for colorectal cancer in residents of Jiading Community

摘要

摘要:
目的了解上海市嘉定镇社区居民采取不同方式开展大肠癌筛查的效果。
方法采用常态化门诊主动筛查和集中式被动筛查两种方式，对符合筛查条件的居民开展大肠癌危险度评估和2次大便隐血检查，对初筛阳性者通知其肠镜检查，掌握动态，做好追踪随访，并对确诊为大肠癌的患者纳入肿瘤人群管理。
结果4 455名参与大肠癌筛查居民中采取门诊筛查的居民占30.75%，被动筛查的占69.25%；女性占58.38%，男性占41.62%；年龄分组以50~69岁居多，占87.70%。初筛总阳性率为20.97%，两种筛查方式相比，门诊主动筛查的初筛阳性率高于被动筛查(P < 0.01)；肠镜检查顺应性方面，门诊主动筛查的肠镜检查率远高于集中式被动筛查(P < 0.01)。通过肠镜检查发现，门诊主动筛查组癌前病变的检出率高于集中式被动筛查(P < 0.05)。
结论建立以门诊主动筛查为主，集中式被动筛查为辅助的筛查模式，能充分发挥大肠癌筛查的整体作用。

Abstract:
ObjectiveTo investigate the effect of different ways of colorectal cancer screening in the community residents of Jiading town.
MethodsBy means of centralized passive screening and outpatient initiative screening, colorectal cancer screening was carried out for residents who qualified for screening.Those with positive result were informed to do colonoscopy and followed up.
Resultsoutpatient screening was done in 30.75% of the 4 455 participated residents and centralized passive screening in 69.2%, of whom female was 58.38% and male 41.62%.Groups that ranged from 50 to 69 years old accounted for 87.70%.The total positive rate of preliminary screening was 20.97%.By comparison of the two modes, the outpatient screening was found to be higher in initial screening positive rate than centralized screening(P < 0.01).As compliance with colonoscopy, the colonoscopy rate with outpatient screening was far higher than with centralized screening(P < 0.01).By colonoscopy it was found that outpatient screening group was higher than centralized screening in the detection rate for precancerous lesions(P < 0.05).
ConclusionTo establish the modes of outpatient initiative screening as primary and centralized passive screening as auxiliary can give full play to their overall role of colorectal cancer screening.

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