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目的了解松江区石湖荡镇居民大肠筛查结果,大肠镜检率和依从性,分析潜在的影响因素,以采取相应改善措施。方法采用整群抽样法,将石湖荡镇11个行政村和2个街道的年龄≥40岁居民作为调查对象,经知情同意后共调查9 086人。结果 9 086名居民中,男性4 250人(46.78%),女性4 836人(53.22%);最小年龄40岁,最大年龄82岁,平均年龄(59.26±7.81)岁。危险度判定阳性率11.07%,粪便潜血检查阳性率30.57%,3 707名高危对象实际镜检率12.49%,组织活检确诊大肠癌9例(大肠癌检出率99.05/10万),多因素分析显示,年龄是影响居民大肠癌镜检率的主要因素,年龄越大,镜检率越高(OR=1.99,2.17);未镜检的原因主要包括自己认为没有必要(68.46%),担心不适(31.47%)。结论松江区石湖荡镇居民大肠癌危险因素暴露率和FOTB阳性率高,同时大肠镜检率偏低,大肠癌检出率存在低估。建议政府加大宣传力度,提高居民对大肠癌筛查镜检的认识,改进操作手法,推广无痛肠镜技术,提高镜检接受度和筛查效果,提高大肠癌早期诊断率。
Objective To understand the results of colon screening, colonoscopy and compliance of residents in Shihuodang Town, Songjiang District, and to analyze the potential influencing factors so as to take appropriate measures for improvement. Methods The method of cluster sampling was used to investigate the population aged ≥40 years in 11 administrative villages and 2 streets of Shihudang Town. After informed consent, a total of 9 086 people were investigated. Results Among 9 086 residents, 4 250 (46.78%) were male and 4836 (53.22%) were female. The youngest was 40 years old, the oldest was 82 years old and the mean was 59.26 ± 7.81 years old. The positive rate of risk judgment was 11.07%, the positive rate of fecal occult blood test was 30.57%, the actual microscopic examination rate of 3 707 high risk subjects was 12.49%, the tissue biopsy confirmed 9 cases of colorectal cancer (the detection rate of colorectal cancer was 99.05 / 100000), the multivariate analysis Showed that age is the main factor affecting the incidence of colorectal cancer, the higher the age, the higher the rate of microscopic examination (OR = 1.99, 2.17); the reasons of not including microscopic examination mainly include the fact that it is not necessary (68.46%), (31.47%). Conclusion The incidence of colorectal cancer risk factors and FOTB positive rate in residents of Shihuodang Town in Songjiang District are high. Meanwhile, the detection rate of colorectal cancer is low, and the detection rate of colorectal cancer is underestimated. It is recommended that the government step up publicity efforts to raise residents’ awareness of colorectal cancer screening, improve operation practices, promote painless colonoscopy, improve microscopic acceptance and screening results, and improve the early diagnosis rate of colorectal cancer.