内蒙古城市社区居民2017 — 2018年肺癌风险评估及筛查结果分析

席云峰; 张星光; 乔丽颖; 董玮琪; 夏远

doi:10.11847/zgggws1126567

内蒙古城市社区居民2017 — 2018年肺癌风险评估及筛查结果分析

Lung cancer risk and screening outcome among 40 – 74 years old urban community residents in Inner Mongolia autonomous region: 2017 – 2018

摘要

摘要:
目的了解内蒙古城市社区居民2017 — 2018年肺癌风险评估及筛查结果，为肺癌和肺内结节的预防控制提供参考依据。
方法于2017年3月 — 2018年12月采用整群随机抽样方法在内蒙古呼和浩特市和通辽市抽取6个社区共70 027名40～74岁常住居民进行肺癌风险评估，应用低剂量螺旋CT（LDCT）对肺癌高风险人群进行临床筛查。
结果内蒙古70 027名城市社区居民中，检出肺癌高风险人群15 753人，肺癌高风险人群检出率为22.50 %；肺癌高风险人群中有6 265人参与LDCT筛查，筛查参与率为42.47 %。6 265名参与筛查的高风险人群中，肺癌或疑似肺癌病灶、肺内结节、肺气肿、肺囊肿、小气道病变、肺间质病变、肺纤维瘢痕和肺不张分别检出37、1 219、694、277、197、172、1 335和132例，检出率分别为0.59 %、19.46 %、11.08 %、4.42 %、3.14 %、2.75 %、21.31 % 和2.11 %。多因素非条件logistic回归分析结果显示，年龄 ≥ 50岁、体育锻炼、生活环境空气污染、有肺气肿病史和精神压抑是内蒙古肺癌高风险人群检出肺内结节的危险因素；蒙古族、二手烟暴露年限为1～14年、经常饮酒、职业为商人、农民、工人和其他是内蒙古肺癌高风险人群检出肺内结节的保护因素。
结论内蒙古城市社区居民肺癌高风险人群筛查参与率较低，年龄、民族、职业、二手烟暴露年限、经常饮酒情况、体育锻炼情况、生活环境空气污染情况、肺气肿病史和精神压抑情况是该地区肺癌高风险人群检出肺内结节的主要影响因素。

Abstract:
Objective To explore lung cancer risk and to analyze screening outcomes among middle-aged and elderly urban community residents in Inner Mongolia autonomous region for providing evidences to lung cancer prevention in the population.
Methods We recruited 70 027 permanent residents aged 40 – 74 years in 6 urban communities in two cities of Inner Mongolia autonomous region with cluster random sampling. Using approaches and questionnaire for Cancer Screening Program in Urban China, we carried out a face-to-face interview to assess lung cancer risk among the residents and a low-dose computed tomography (LDCT) screening for lung cancer among the residents with high cancer risk from March 2017 to December 2018.
Results Of all the participants, 15 753 (22.50%) were assessed as with high risk of lung cancer and of the high risk individuals, 6 265 (42.47%) received LDCT examination. The pulmonary abnormalities detected among the LDCT examinees included suspected cancer (37 cases, 0.59% of the examinees), nodule (1 219, 19.46%), emphysema (694, 11.08%), cyst (277, 4.42%), small airway lesion (197, 3.14%), interstitial disorder (172, 2.75%), fiber scar (1 335, 21.31%), and atelectasis (132, 2.11%). Unconditional multivariate logistic regression analysis revealed that aged ≥ 50 years, having physical exercise, ambient air pollution in living environment, with history of emphysema, and having long-term mental depression were significant risk factors of having pulmonary nodule in LDCT detection but being Mongolian ethnic, exposure to second hand smoke for 1 – 14 years, drinking alcohol frequently, being business men/farmers/workers/other unspecific occupation were significant protective factors of pulmonary nodule among the participants assessed at high risk of lung cancer.
Conclusion In Inner Mongolia autonomous region for the middle-aged and elderly urban community residents with high risk lung cancer, the participation rate of computed tomography for cancer screening is relatively low and the detection rate of pulmonary nodules is associated with age, ethnic group, occupation, years of second hand smoke exposure, alcohol drinking, physical exercise, residential air pollution, history of emphysema, and long-term mental depression.

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