目的探讨河南省城市癌症早诊早治项目中结肠镜筛查人群结直肠进展期肿瘤检出情况及其影响因素。
方法采用横断面研究设计，依托河南省城市癌症早诊早治项目，以2013年10月至2019年10月在河南省郑州市、驻马店市、安阳市、洛阳市、南阳市、焦作市、新乡市和濮阳市招募的无症状参与结肠镜筛查的7 454名城市居民为研究对象，采用χ 2检验比较不同特征人群的结直肠进展期肿瘤检出率，采用多因素logistic回归模型分析结直肠进展期肿瘤检出的影响因素。
结果接受结肠镜筛查的7 454人中共检出进展期肿瘤112例，检出率为1.50%。多因素logistic回归分析显示，年龄、吸烟史、肉类摄入量、糖尿病史和一级亲属结直肠癌家族史是结直肠进展期肿瘤检出的独立影响因素。与40～49岁组相比，60～74岁组检出结直肠进展期肿瘤的风险增高（ OR=2.04，95% CI：1.23～3.38）；与不吸烟人群相比，正在吸烟的人群检出结直肠进展期肿瘤的风险增高（ OR=2.21，95% CI：1.48～3.31）；与肉类摄入量较少的人群相比，肉类摄入量较多的人群检出结直肠进展期肿瘤的风险增高（ OR=1.53，95% CI：1.04～2.26）；与无糖尿病史的人群相比，有糖尿病史的人群检出结直肠进展期肿瘤的风险增高（ OR=1.69，95% CI：1.07～2.69）；与无一级亲属结直肠癌家族史的人群相比，有一级亲属结直肠癌家族史的人群检出结直肠进展期肿瘤的风险增高（ OR=1.64，95% CI：1.09～2.46）。
结论河南省城市癌症早诊早治项目中结肠镜筛查结直肠进展期肿瘤的检出率为1.50%，高龄、吸烟、肉类摄入较多、糖尿病史、结直肠癌一级亲属家族史是结直肠进展期肿瘤的危险因素。
ObjectiveTo analyze the detection of colorectal advanced neoplasms in the population who underwent colonoscopy screening in Henan Province as part of the Urban China Cancer Screening Program and its influencing factors.
MethodsA cross-sectional study design was employed. Based on the Cancer Screening Program conducted in Henan Province, the study enrolled 7 454 urban residents who manifested no symptoms and were recruited from eight cities in the province, including Zhengzhou, Zhumadian, Anyang, Luoyang, Nanyang, Jiaozuo, Xinxiang, and Puyang from October 2013 to October 2019, and participated in colonoscopy screening. The χ 2 test was used to compare the detection rates of colorectal advanced neoplasms among participants with different characteristics, and a multivariate logistic stepwise regression model was used to analyze the factors affecting the detection rates.
ResultsA total of 7 454 subjects underwent colonoscopy screening, and 112 cases of colorectal advanced neoplasms were detected. Multivariate logistic regression analysis suggested that older age, smoking, higher meat intake, history of diabetes, and family history of colorectal cancer in a first-degree relative were risk factors for colorectal advanced neoplasms. The detection rate was significantly higher in people aged 60-74 years compared with those aged 40-49 years, with an odds ratio ( OR) of 2.04 (95% CI: 1.23-3.38).The rates were higher in people who smoked than those who did not smoke, with an OR of 2.21 (95% CI: 1.48-3.31), and in people who consumed more meat than those who consumed less, with an OR of 1.53 (95% CI: 1.04-2.26). Those with diabetes had a higher detection rate compared with those without, with an OR of 1.69 (95% CI: 1.07-2.69), and those with a first-degree family history of colorectal cancer had a higher detection rate than those without, with an OR of 1.64 (95% CI: 1.09-2.46).
ConclusionThe detection rate of colorectal advanced neoplasms through colonoscopy screening in Henan Province covered by the Urban China Cancer Screening Program is 1.50%. Older age, smoking, higher meat intake, history of diabetes, and family history of colorectal cancer in a first-degree relative are identified as risk factors for colorectal advanced neoplasms.
郭兰伟,郑黎阳,陈琼,等. 河南省城市地区结肠镜筛查人群结直肠进展期肿瘤检出情况及其影响因素分析[J]. 中华肿瘤杂志,2024,46(08)：794-800.
DOI:10.3760/cma.j.cn112152-20231026-00272版权归中华医学会所有。
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除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。
郭兰伟：数据整理、统计学分析、论文撰写、经费支持；郑黎阳、陈琼、刘茵、徐慧芳、康瑞华、王红、王潇杨、刘曙正：数据整理、统计学分析；张韶凯：研究指导、论文修改、经费支持
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