倪海峰 李元召 万燕萍

摘 要 目的：了解上海市某社區居民大肠癌筛查情况，为促进本社区大肠癌早发现工作提供依据。方法：2019年5-9月对辖区50岁及以上居民采用问卷调查法及大便隐血试验（FOBT）进行初筛，其中男性1 752名；女性3 005名。年龄为50～74岁，平均年龄为（63.72±6.54）岁。建议初筛阳性者至定点医院进一步检查。结果：在4 757名居民中，慢性便秘、慢性胆囊炎、慢性阑尾炎在大肠癌危险因素分布中占的比例较高，分别为10.99%、10.53%、10.26%；初筛阳性例数为1 618人，阳性率为34.01%，其中301初筛阳性者参加了肠镜检查，检查率为18.60%。在肠镜检查者中，检出癌前病变19例，检出率为6.31%，确诊大肠癌4例，检出率1.33%。结论：辖区大肠癌初筛阳性率较高，肠镜的检查率较低。今后应加强社区居民健康宣教，提升早期筛查意识，提高大肠癌筛查的顺应性。

关键词 大肠癌；社区；筛查

中图分类号：R735.3+4 文献标志码：A 文章编号：1006-1533（2020）04-0041-03

Analysis of screening results of colorectal cancer among residents in a community in Jiading District of Shanghai

NI Haifeng1， LI Yuanzhao2， WAN Yanping2

（1.Office of Malu Community Health Service Center of Jiading District， Shanghai 201801， China； 2.Prevention and Health Care Department of Malu Community Health Service Center of Jiading District， Shanghai 201801， China）

ABSTRACT Objective： To understand the status of colorectal cancer screening for residents in a certain community in Shanghai， and to provide evidence for early detection of colorectal cancer in this community. Methods： From May to September， 2019， the questionnaire survey and fecal occult blood test （FOBT） were used for a preliminary screening of residents aged 50 years and over in the jurisdiction， there were 1 752 males and 3 005 females. The age ranged from 50 to 74 years old， with an average age of （63.72±6.54） years old. It was recommended that those who were initially screened positive to go to a designated hospital for further examination. Results： In the 4 757 residents， chronic constipation， chronic cholecystitis， and chronic appendicitis accounted for a relatively high proportion of the distribution of colorectal cancer risk factors， which were 10.99%， 10.53%， and 10.26%， respectively； the number of positive cases in the initial screening was 1 618， and the positive rate was 34.01%. Among them， 301 who were initially screened positive participated in colonoscopy， and the examination rate was 18.60%. In colonoscopy， 19 cases of precancerous lesions were detected， the detection rate was 6.31%， 4 cases of colorectal cancer were diagnosed， and the detection rate was 1.33%. Conclusion： The pre-screening positive rate for colorectal cancer is higher in the jurisdiction， and the rate of colonoscopy is lower. In the future， it is necessary to strengthen the health education for the community residents， enhance the awareness of early screening， and improve the compliance of colorectal cancer screening.

KEY WORDS colorectal cancer； community； 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，大肠癌的发病率和死亡率逐年上升[1]。上海的大肠癌发病率从上世纪70年代的第5位上升到近年来的第2位，并且每年以4.2%左右的速度上升[2]，严重威胁着广大人民的身体健康和生活质量。因此，国内外学者建议应定期开展大肠癌的筛查工作，以提高患者的生存率，改善生存质量[3]。上海市于2013年启动了“上海市社区居民大肠癌筛查” 项目，旨在提高市民大肠癌防治知识知晓率，提高大肠癌及癌前病变早期诊断率和治疗率，降低大肠癌死亡率和未来发病率[4]。本文旨在分析上海市嘉定区某社区居民大肠癌筛查的结果。……