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目的在城市社区自然人群中开展大肠癌筛查,探索开展城市居民恶性肿瘤二级预防措施。方法应用中国癌症基金会推荐的筛查试行方案,以结合免疫法FOB和问卷调查为初筛,肠镜为复筛的方法对杭州一城市社区40岁以上居民开展大肠癌的筛查。结果在实际筛查的6 089人,FOB阳性157例,阳性率为2.6%,问卷调查阳性859,阳性率为14.1%。免疫法FOB合并问卷总阳性率为16.7%,大肠癌筛查方案可浓缩高危人群至15%左右。在FOB阳性的157例中,28例进行了进一步的肠镜检查,发现了5例结肠癌,8例结直肠腺瘤和息肉,12例慢性肠道疾病。在检出的5例大肠癌中,1例未手术,Dukes A期和Dukes C期各2例。结论大肠癌筛查方案可明显浓缩高危人群,大大降低筛查的工作量。免疫法FOB能比较有效地从无症状的城市居民中检出早期大肠癌和癌前病变。
Objective To develop colorectal cancer screening among natural populations in urban communities and to explore secondary prevention measures for urban residents’ malignant tumors. METHODS: The screening program recommended by the China Cancer Foundation was used. Screening with combined immunoassay (FOB) and questionnaires was conducted. Colonoscopy was used as a screening method to screen patients with colorectal cancer over 40 years old in a community in Hangzhou. Results In the actual screening of 6 089 people, FOB was positive in 157 cases, the positive rate was 2.6%. The questionnaire survey was positive 859, and the positive rate was 14.1%. The total positive rate of the immunology FOB combined questionnaire was 16.7%, and the screening program for colorectal cancer could concentrate about 15% of high-risk groups. Of the 157 FOB-positive patients, 28 underwent further colonoscopy. 5 colon cancers, 8 colorectal adenomas and polyps, and 12 chronic intestinal diseases were identified. Of the 5 colorectal cancers detected, 1 was unoperated, and 2 were Dukes A and Dukes C. Conclusion The screening program for colorectal cancer can significantly enrich high-risk groups and greatly reduce the workload of screening. Immunization FOB can effectively detect early colorectal cancer and precancerous lesions from asymptomatic urban residents.