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2013—2023年上海市浦东新区居民大肠癌筛查数据分析

Analysis of Screening Data for Colorectal Cancer in Residents in Pudong New Area, Shanghai, 2013-2023

  • 摘要:
    目的 分析上海市浦东新区居民大肠癌筛查基本情况,为大肠癌筛查项目推广和策略优化提供参考。
    方法 以2013—2023年上海市浦东新区参加大肠癌筛查项目的50~74岁居民为研究对象,分析初筛和肠镜检查情况,同时根据年龄开展亚组分析。组间比较采用卡方检验。
    结果 2013—2023年浦东新区大肠癌完成社区初筛907 030人次,其中初筛阳性183 724人次,整体初筛阳性率为20.3%,50~54岁年龄组最低,70~74岁年龄组最高,男性初筛阳性率大于女性。总体肠镜检查参与率为27.1%,男、女性肠镜检查参与度最高的年龄段分别为50~54岁和55~59岁,肠镜检查参与率随着每轮筛查的开展有增加趋势。经肠镜检查发现肠道病变19 094例,其中大肠癌1 147例,占6.0%,人群检出率为126.5/10万;癌前病变4 751例,占24.9%,人群检出率为523.8/10万。
    结论 大肠癌筛查有效提高了癌前病变及早期癌检出率,对于降低大肠癌发病率和死亡率具有重要意义。尚需针对年龄亚组采取措施优化筛查策略,提高初筛参与率和肠镜检查参与率,从而进一步提升大肠癌的防治效果。

     

    Abstract:
    Objective To analyze the colorectal cancer screening of community residents in Pudong New Area in Shanghai and provide reference for the promotion and strategy optimization of colorectal cancer screening programs.
    Methods Residents aged 50-74 years in the colorectal cancer screening project of Pudong New Area in Shanghai from 2013 to 2023 were recruited in this analysis. The situation of primary screening and colonoscopy in the community was described, and results of different age groups in primary screening and colonoscopy surveys were evaluated. Chi-square test was used to determine differences between groups.
    Results From 2013 to 2023, 907 030 residents were screened in Pudong New Area, of which 183 724 residents were positive, and the positive rate was 20.3%. The positive rate was the lowest in the 50-54 age group and the highest in the 70-74 age group. The positive rate was higher in men than in women. The overall colonoscopy rate was 27.1%, with the highest rates in the 50-54 age group in men and the 55-59 age group in women, respectively. The participation rate of colonoscopy increased with the increase of the year. A total of 19 094 cases of intestinal lesions were found by colonoscopy. Among these lesions, 1 147 cases were colorectal cancer, accounting for 6.0%, and the population detection rate was 126.5/100 000. In addition, 4 751 cases of precancerous lesions were found, accounting for 24.9%, and the detection rate was 523.8/100 000.
    Conclusion Colorectal cancer screening improves the detection rate of precancerous lesions and early cancer and is of great significance for reducing the incidence and mortality of colon cancer. Measures should be taken to optimize the screening strategy based on age differences and increase the participation rate of primary screening and colonoscopy to achieve the best effect of local colorectal cancer prevention and treatment.

     

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