分析2015—2017年中国城市早诊早治项目地区居民肿瘤早发现意识现况及相关因素。
采用横断面调查的方法，于2015—2017年以2015年度"城市癌症早诊早治项目"覆盖的16个项目省份为研究现场，采用整群及方便抽样的方法，将年龄≥18岁、能够理解调查程序的居民纳入研究。共纳入32 257名研究对象，社区居民、癌症风险评估/筛查干预人群、现患癌症患者及职业人群分别有15 524、8 016、2 289、6 428名。采用自制的调查问卷收集人口、社会经济学指标、自我患癌风险评价、是否定期参加体检等信息，并采用多因素logistic回归模型分析近5年未定期体检者体检意愿的相关因素。
研究对象中自评具有患病风险、不具有患病风险、不清楚者分别占27.54%、45.48%和26.98%；其中自评具有患癌风险者考虑体检的比例占79.84%。近5年参加定期体检、未定期体检者分别占65.43%和34.56%。多因素logistics回归模型分析结果显示，离婚人群、中部和东部的受访者的参加定期体检的意愿更为积极（P值均<0.05）；2014年家庭年收入在2.0万元~3.9万元者、4.0万元~5.9万元者、职业人群、社区居民、现患癌症患者、自评无患癌风险人群及不清楚自己患癌风险者参加体检的意愿较低（P值均<0.05）。
2015—2017年中国城市早诊早治项目地区居民肿瘤早发现意识较好；婚姻状况、家庭收入、人群分组、自我患病风险评价与近5年未定期参加体检者定期参加体检的意愿相关。
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中国医学科学院医学信息研究所公共卫生战略情报研究室，北京 100020
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室，北京 100021
中国医学科学院医学信息研究所公共卫生战略情报研究室，北京 100020
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室，北京 100021
中国医学科学院医学信息研究所公共卫生战略情报研究室，北京 100020
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院药物临床试验研究中心，北京 100021
中国医学科学院医学信息研究所公共卫生战略情报研究室，北京 100020
安徽医科大学卫生管理学院，合肥 230032
哈尔滨医科大学公共卫生学院 150081
湖南省肿瘤医院肿瘤防治办公室，长沙 410006
兰州大学公共卫生学院流行病与卫生统计学研究所 730000
山东大学医药卫生管理学院，济南 250012
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室，北京 100021
广西医科大学公共卫生学院，南宁 530021
安徽省肿瘤医院防癌科，合肥 230032
哈尔滨医科大学附属肿瘤医院肿瘤防治办公室 150081
重庆大学附属肿瘤医院 重庆市肿瘤研究所 重庆市肿瘤医院肿瘤防治办公室 400030
甘肃省肿瘤医院肿瘤流行病研究中心，兰州 730050
山西省肿瘤医院流行病室，太原 030013
云南省疾病预防控制中心慢性非传染性疾病防制所，昆明 650118
江苏省疾病预防控制中心慢性非传染性疾病防制所，南京 210009
山东省肿瘤医院肿瘤防治办公室，济南 250117
山东省肿瘤医院肿瘤防治办公室，济南 250117
辽宁省疾病预防控制中心慢性非传染性疾病防制所，沈阳 110005
辽宁省肿瘤医院肿瘤防治办公室，沈阳 110042
新疆医科大学附属肿瘤医院肿瘤防治研究所，乌鲁木齐 830011
郑州大学附属肿瘤医院 河南省肿瘤医院肿瘤防治研究办公室 450008
中国科学院大学附属肿瘤医院 浙江省肿瘤医院肿瘤防治科，杭州 310022
河北医科大学第四医院肿瘤研究所肿瘤防治办公室，石家庄 050011
徐州市疾病预防控制中心慢性非传染性疾病控制科 221006
南通市疾病预防控制中心健康教育与慢性病防制科 226000
宁波市第二医院内分泌科 315010
开滦总医院心血管内科，唐山 063000
唐山市人民医院癌症早诊早治办公室 063001
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院防癌科，北京 100021
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室，北京 100021
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室，北京 100021
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室，北京 100021
中国医学科学院医学信息研究所公共卫生战略情报研究室，北京 100020
国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室，北京 100021
国家重大公共卫生服务项目城市癌症早诊早治项目；国家重点研发计划
（2017YFC0910100、2018YFC1313100）
北京城市癌症早诊早治项目卫生经济学评价；中国医学科学院医学与健康科技创新工程项目
（2016-12M-2-004、2017-I2M-1-006、2019-I2M-2-004）
国家自然科学基金
（81773521、8197121078）
毛阿燕和石菊芳对本文有同等贡献
利益冲突 所有作者均声明不存在利益冲突
To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017.
A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years.
The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05).
From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.
Neoplasms; Health literacy; Cross-sectional; Weaker detection; Urban population
Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
Health Management College, Anhui Medical University, Hefei 230032, China
School of Public Health, Harbin Medical University, Harbin 150081, China
The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
School of Public Health, Lanzhou University, Lanzhou 730000, China
School of Health Care Management, Shandong University, Jinan 250012, China
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
School of Public Health, Guangxi Medical University, Nanning 530021, China
Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
The Department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control,Kunming 650118, China
Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
The Department of Cancer Prevention and Control, Liaoning Cancer Hospital &
Institute, Shenyang 110042, China
Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
Department of Cancer Prevention, Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310022, China
The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010,China
Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
Office of Cancer Screening, Tangshan People′s Hospital, Tangshan 063001, China
Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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