朱景新+黄文兰+徐永正

摘 要 目的：总结和分析奉贤东部地区居民大肠癌筛查情况，提出推动远郊地区大肠癌筛查工作的相关建议。方法：利用问卷调查和粪便隐血试验（FOBT）对奉贤东部4个社区50～74岁居民进行初筛，初筛出的高危人群做大肠镜检查，对结果进行临床分析。结果：4个社区共作大肠癌筛查9 168人，初筛出高危人群1 629人，阳性率为17.77%，其中586人接受肠镜检查，检出结直肠疾病124例，检出率为21.16%，其中大肠癌7例、息肉116例、肠炎1例。结论：在社区开展问卷调查联合FOBT可以有效地发现结直肠癌及癌前病变的高危人群，再作肠镜检查，达到早期诊断，但肠镜检查的顺应性偏低，需加强宣教动员，并优化配套方案及制定政策保障。

关键词 大肠癌 远郊地区 高危人群 筛查

中图分类号：R735.3+4 文献标识码：A 文章编号：1006-1533（2016）06-0057-03

Analysis of the screening results of colorectal cancer in the Eastern Fengxian District of the outer suburbs of Shanghai

ZHU Jingxin， HUANG Wenlan， XU Yongzheng

（1.Haiwan Tourist Area Health Service Center of Fengxian District， Shanghai 201418， China； 2.Pingan Community Health Service Center of Fengxian District， Shanghai 201413， China； 3.Central Hospital of Fengxian District， Shanghai 201499， China）

ABSTRACT Objective： To summarize and analyze the screening of colorectal cancer in the residents in Eastern Fengxian District to put forward the relevant suggestions to promote the work of screening colorectal cancer in the outer suburbs. Methods： The residents aged from 50 to 74 years old in four communities were preliminarily screened with the questionnaire survey and fecal occult blood test （FOBT）， the high-risk population screened out was examined by the electronic colonoscopy， and the result was analyzed clinically. Results： In the 4 communities， 9 168 cases were preliminarily screened for colorectal cancer， 1 629 cases were screened out as the high-risk population， and the positive rate was 17.77%. Among the high-risk population， 586 cases were examined by the colonoscopy， and 124 cases were detected to have colorectal disease， including 7 cases of colorectal cancer， 116 ones of colorectal polyps， and 1 one of enteritis and the detection rate was 21.6%. Conclusion： In the community， implementation of the questionnaire survey and FOBT can effectively discover the high-risk population of colorectal disease and precancerous lesion and then the electronic colonoscopy is recommended to achieve the early diagnosis. But the colonoscopy compliance was low， the propaganda and mobilization need to be strengthened and the supporting scheme should be optimized and policy be formulated to guarantee the work.

KEY WORDS colorectal cancer； suburban areas； high-risk population； screening

随着经济的发展，居民生活水平的提高和饮食习惯的改变，肠癌的发病率和死亡率逐年上升。上海的大肠癌发病率从上世纪70年代的第五位上升到近年来的第二位，并且每年以4.2%左右的速度上升[1]。作为一种危害我国人民健康的恶性肿瘤，结直肠癌已被列入我国癌症预防与控制规划纲要中重点防治的八种癌症之一，建议早期诊断及综合防治。上海远郊农村地区由于地域、文化及经济水平限制，对于结直肠癌的诱发因素、临床表现、早期诊治等防治知识了解甚少。本研究通过社区全科服务团队平台，对上海远郊奉贤的东部地区人群进行了结直肠癌的筛查，通过总结工作经验，比较筛查效果，分析存在不足，以期为日后大肠癌筛查工作及制定相关策略提供参考。……