| 师苗苗,梁 迪,师 金,等.2016—2022年河北省城市地区结直肠癌筛查和随访结果分析[J].中国肿瘤,2023,32(6):423-430. |
| 2016—2022年河北省城市地区结直肠癌筛查和随访结果分析 |
| Results of Colorectal Cancer Screening and Follow-Up in Urban Areas of Hebei Province from 2016 to 2022 |
| 投稿时间：2022-12-06 |
| DOI：10.11735/j.issn.1004-0242.2023.06.A004 |
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| 中文关键词: 结直肠癌 筛查 早诊早治 河北 |
| 英文关键词:colorectal cancer screening early diagnosis and treatment Hebei |
| 基金项目: |
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| 摘要点击次数: 471 |
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| 中文摘要: |
| 摘 要：［目的］ 分析2016—2022年河北省城市癌症早诊早治项目结直肠癌筛查及随访结果。［方法］ 以2016—2022年河北省城市癌症早诊早治项目覆盖的唐山市、石家庄市、邢台市、邯郸市为研究区域，面向40~74岁常住居民，进行问卷调查和结直肠癌风险评估，对评估出的高危人群进行结肠镜筛查。分析结直肠癌高危率、筛查参与率和阳性病变检出率。对结直肠癌检出率和确诊结直肠癌患者的临床特征等方面进行比较分析。［结果］ 2016—2022年研究队列共纳入问卷调查且符合入组条件的居民211 399人，评估为结直肠癌高危人群45 365人，高危率为21.46%；参与结肠镜筛查9 574人，参与率为21.10%。检出结直肠癌43例，检出率为0.45%；检出癌前病变1 153例，检出率为12.04%。队列中位随访3.2年，在所有研究对象中，确诊结直肠癌395例，结直肠癌累积发病率0.19%。在结肠镜筛查组，检出结直肠癌65例，累积发病率0.68%；评估为结直肠癌高危人群但未进行筛查者中，结直肠癌发病79例，累积发病率0.22%；低危组结直肠癌发病251例，累积发病率0.15%。结直肠癌筛查组检出Ⅰ～Ⅳ期结直肠癌的比例分别为44.74%、28.95%、21.05%、5.26%；在非筛查组中，相应的比例分别为11.43%、39.43%、34.29%、14.86%。筛查组检出早期结直肠癌（Ⅰ期）比例为44.74%，显著高于非筛查组（11.43%）。筛查组中确诊结直肠癌位于右半结肠、左半结肠和直肠的比例分别为24.62%、12.31%、38.46%；在非筛查组中，相应的比例分别为15.15%、16.36%、49.70%。［结论］ 结直肠癌高危人群筛查参与率有待提高。应用结肠镜在高危人群中进行结直肠癌筛查，有助于发现早期病例，达到早诊早治的目的。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the results of colorectal cancer screening and follow-up results in urban areas of Hebei Province from 2016 to 2022. ［Methods］ From 2016 to 2022， the colorectal cancer screening programs were conducted in 4 cities of Hebei Province (Tangshan， Shijiazhuang， Xingtai and Handan). The questionnaire survey and colorectal cancer risk assessment were applied for residents aged 40~74 years old in urban areas； and colonoscopy examination was performed for high risk participants. The high-risk rate of colorectal cancer， participation rate and detection rate of positive results were analyzed. The clinical characteristics of detected colorectal cancer were analyzed. ［Results］ From 2016 to 2022， a total of 211 399 eligible residents participated in the screening program， among whom 45 365 were assessed as high-risk subjects for colorectal cancer with a high-risk rate of 21.46%； in the high-risk population 9 574 underwent colonoscopy with a compliance rate of 21.10%. Forty-three cases of colorectal cancer were detected with a detection rate of 0.45%. A total of 1 153 cases of precancerous lesions were detected with a detection rate of 12.04%. The median follow-up time was 3.2 years. During the follow-up， 395 new cases of colorectal cancer were diagnosed， and the cumulative incidence of colorectal cancer was 0.19%. Among participants receiving colonoscopy， 65 cases of colorectal cancer were detected with a cumulative incidence rate of 0.68%. In the high-risk participants without screening group， 79 cases of colorectal cancer were diagnosed with a cumulative incidence rate of 0.22%. In the low-risk group， 251 cases of colorectal cancer were diagnosed occurred during the follow-up with a cumulative incidence rate was 0.15%. The proportion of Ⅰ～Ⅳ stage colorectal cancer in screening group were 44.74%， 28.95%， 21.05% and 5.26%， respectively； while in the non-screening group， the corresponding proportions were 11.43%， 39.43%， 34.29% and 14.86%， respectively. The detection rate of stage Ⅰ in screening group was 44.74%， which was significantly higher than that in non-screening group (11.43%). In the screening group， the proportions of colorectal cancer in the right colon， left colon and rectum were 24.62%， 12.31% and 38.46%， respectively； while in the non-screening group， the corresponding proportions were 15.15%， 16.36% and 49.70%，respectively. ［Conclusion］ The study indicates that screening for colorectal cancer among residents can increase the detective rate of colorectal cancer in early stage， particularly among high-risk participants who receive colonoscopy examination. However， the compliance rate of colonoscopy is still low， which need to be further improved. |
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