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目的:评价序贯粪隐血试验自然人群连续性大肠癌普查在提高大肠癌患者长期存活率和降低大肠癌发病率的作用. 方法:1987/2002年,我们应用序贯粪隐血试验(SFOBT), 对3 002名51-92自然人群进行1次/a的大肠癌普查. 结果:该人群中2 251人接受了普查(A组),751人未能接受普查(B组),普查率为74.98%.16 a中共发现大肠癌44 例,年平均大肠癌发生率为91.61/105.A组检出21例大肠癌,漏检6例大肠癌,大肠癌发生率为74.97/105,大肠癌检出率为58.31/105,B组发现17例大肠癌,大肠癌发生率为141.478/105.A组中94.44%的大肠癌为Dukes A、B期,B组中29.42%为Dukes A、B期.两组大肠癌患者的5 a存活率分别为75%和133.33%.A组中检出497 例大肠腺瘤,均在肠镜下切除,16 a随访中仅1例恶变. SFOBT的大肠癌阳性检出率为77.77%,假阴性率为7.69%, 阳性预示值为2.52%. 结论:高龄自然人群普查可检出大部分早期和较早期大肠癌,普查出的患者有较高的5 a存活率;切除普查发现的大肠腺瘤,并进行肠镜随访,可明显降低大肠癌的发生;序贯粪隐血试验虽可以获得很好的普查效果,然而假阳性率过高仍是该方案的缺陷.
OBJECTIVE: To evaluate the effect of continuous colorectal cancer screening (CNCP) on the long-term survival rate and the incidence of colorectal cancer in patients with sequential fecal occult blood test.Methods: In 1987/2002, we used sequential stool occult blood test (SFOBT) A total of 3 002 51-92 human subjects underwent colorectal cancer screening once per year.Results: Of the population, 2 251 were enrolled (group A), 751 were not enrolled (group B), and the census rate was 74.98 % .16 a Colorectal cancer were found in 44 cases, the average annual incidence of colorectal cancer was 91.61 / 105. A group of 21 cases of colorectal cancer detected, missed 6 cases of colorectal cancer, the incidence of colorectal cancer was 74.97 / 105, colorectal cancer Out rate was 58.31 / 105, 17 cases of colorectal cancer and 141.478 / 105 of colorectal cancer were found in group B. 94.44% of colorectal cancers in group A were Dukes A and B, and 29.42% of patients in group B were Dukes A and B .The 5-year survival rates of two groups of patients with colorectal cancer were 75% and 133.33%, respectively.Among them, 497 cases of colorectal adenomas were detected in the group A, all underwent colonoscopy and only 1 case was malignant in 16 years follow-up. The positive detection rate was 77.77%, the false negative rate was 7.69%, the positive predictive value was 2.52% .Conclusion: Most elderly patients with early and early colorectal cancer can be detected by census, Who had a higher 5-year survival rate. Excision of colorectal adenomas by census and follow-up of colonoscopy could significantly reduce the incidence of colorectal cancer. Sequential faecal occult blood test could achieve a good screening effect, however, the false-positive rate Too high is still a flaw in the program.