Outcome analysis of colonoscopy screening for colorectal cancer in high-risk urban population of Shenzhen city: 2017 – 2019
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摘要:
目的 了解广东省深圳市城市结直肠癌高危人群2017 — 2019年的结直肠病变情况,为优化结直肠癌筛查策略提供参考依据。 方法 收集深圳市城市重点癌症早诊早治项目2017年5月 — 2019年8月通过结直肠癌危险因素调查和风险评估系统评估出的40~74岁城市结直肠癌高危人群,对进行问卷调查和肠镜筛查结果分析。 结果 深圳市2017 — 2019年共评估出城市结直肠癌高危人群6260人,其中完成肠镜检查者2622人,肠镜检查依从率为41.88 %;参与肠镜检查且问卷信息填写完整者1371人,检出结直肠癌3例、癌前病变152例、良性息肉473例、炎性肠病86例、良性息肉合并炎性病变38例、其他大肠疾病148例,检出率分别为0.22 %、11.09 %、34.50 %、6.27 %、2.77 %、10.80 %;深圳市不同特征高危人群比较,不同性别高危人群癌前病变、良性息肉和其他大肠疾病检出率不同,不同年龄、体质指数高危人群癌前病变和良性息肉检出率不同,不同新鲜水果、畜肉食用频率高危人群良性息肉合并炎性病变检出率不同,不同口味高危人群癌前病变、良性息肉和其他大肠疾病检出率不同,不同饮茶频率高危人群炎性肠病检出率不同,差异均有统计学意义(均P < 0.05)。 结论 深圳市城市居民结直肠癌高危人群肠镜筛查依从性较好,各结直肠病变检出率较低,不同特征高危人群各类病变检出率不同,应进一步优化结直肠癌筛查方案和精准识别高危人群,以实现结直肠癌的早诊早治。 Abstract:Objective To analyze the results of colonoscopy screening on colorectal cancer among high risk individuals assessed from permanent residents of Shenzhen city during 2017 – 2019 for providing evidence to the optimization of strategies on the screening. Methods Totally 6 2 60 permanent adult residents (aged 40 – 74 years) were assessed as having high risk of colorectal cancer based on the survey results of Major Cancer Early Diagnosis and Treatment Project in Urban Population conducted in Shenzhen city from May 2017 through August 2019. Of the high-risk individuals, 2 622 received colonoscopy examination and the data on 1 371 examinees with complete information of questionnaire interview and clinical examination were analyzed. Results The compliance rate of colonoscopy examination was 41.88% for all the high-risk individuals identified in the project-based survey. Among the 1 371 colonoscopy examinees included in the analysis, the detection rate was 0.22% (3 cases) for colorectal cancer, 11.09% (152) for precancerous lesion, 34.50% (473) for benign polyps, 6.27% (86) for inflammatory bowel disease, 2.77% (38) for benign polyps combined with inflammatory lesion, and 10.80% (148) for other colorectal diseases, respectively. For the 1 371 examinees, the detection rate of precancerous lesions and benign polyps differed significantly by gender, age, body mass index, and salty food preference, while gender and salty food preference were also significantly related to the detection rate of other colon diseases (all P < 0.05); the detection rate of benign polyps combined with inflammatory lesion was influenced significantly by the frequency of fruit and meat consumption (both P < 0.05); and the detection rate of inflammatory bowel disease was significantly associated with tea drinking (P < 0.05). Conclusion In urban Shenzhen, the compliance rate of colonoscopy examination is relatively high but the detection rate of various pathological lesions is low and influenced by multiple demographic and individual characteristics among the adult residents at high risk of colorectal cancer. The results suggest that both the scheme of colorectal cancer screening and the identification of high risk individuals need to be optimized for early diagnosis and treatment of the disease. -
Key words:
- colorectal cancer /
- colonoscopy screening /
- high-risk population /
- urban region
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表 1 深圳市城市不同特征结直肠癌高危人群结直肠病变检出情况比较
特征 高危人数 结直肠癌 癌前病变 良性息肉 炎性肠病 良性息肉合
并炎性病变其他大肠疾病 检出数 检出率(%) 检出数 检出率(%) 检出数 检出率(%) 检出数 检出率(%) 检出数 检出率(%) 检出数 检出率(%) 性别 男性 669 3 0.45 88 13.15 255 38.12 38 5.68 24 3.59 56 8.37 女性 702 0 0 64 9.12 a 218 31.05 a 48 6.84 14 1.99 92 13.11 a 年龄(岁) 40~49 508 0 0 51 10.04 142 27.95 39 7.68 15 2.95 60 11.81 50~59 455 2 0.44 45 9.89 142 31.21 27 5.93 15 3.30 47 10.33 60~69 363 1 0.28 44 12.12 168 46.28 20 5.51 8 2.20 38 10.47 70~74 45 0 0 12 26.67 a 21 46.67 a 0 0 0 0 3 6.67 体质指数 < 18.5 50 0 0 5 10.00 13 26.00 4 8.00 1 2.00 8 16.00 18.5~23.9 621 2 0.32 57 9.18 175 28.18 49 7.89 20 3.22 66 10.63 24.0~27.9 519 0 0 56 10.79 202 38.92 28 5.39 14 2.70 54 10.40 ≥ 28.0 181 1 0.55 34 18.78 a 83 45.86 a 5 2.76 3 1.66 20 11.05 食用新鲜水果频率 从不 134 0 0 12 8.96 52 38.81 5 3.73 10 7.46 16 11.94 < 2.5斤/周 965 3 0.31 109 11.30 331 34.30 59 6.11 21 2.18 101 10.47 ≥ 2.5斤/周 272 0 0 31 11.40 90 33.09 22 8.09 7 2.57 a 31 11.40 食用畜肉频率 从不 45 0 0 3 6.67 17 37.78 3 6.67 3 6.67 3 6.67 ≤ 7两/周 443 2 0.45 47 10.61 138 31.15 32 7.22 18 4.06 48 10.84 > 7两/周 883 1 0.11 102 11.55 318 36.01 51 5.78 17 1.93 a 97 10.99 口味 清淡 134 0 0 14 10.45 52 38.81 12 8.96 4 2.99 17 12.69 适中 783 3 0.38 67 8.56 185 23.63 46 5.88 16 2.04 66 8.43 重盐 454 0 0 71 15.64 a 236 51.98 a 28 6.17 18 3.96 65 14.32 a 饮茶频率 从不 502 1 0.20 57 11.35 165 32.87 43 8.57 13 2.59 56 11.16 不经常 179 0 0 19 10.61 66 36.87 9 5.03 8 4.47 21 11.73 经常 690 2 0.29 76 11.01 242 35.07 34 4.93 a 17 2.46 71 10.29 注:a 各组内比较,P < 0.05。 -
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