山东省2013-2016年农村居民食管癌社会性筛查结果分析

发布时间：2018-12-08 07:43

【摘要】：目的山东省自2006年开始承担国家食管癌早诊早治项目,取得了良好的社会效益。本研究旨在分析山东省2013-2016年食管癌早诊早治项目筛查结果,探讨食管癌筛查的改进策略。方法采用整群随机抽样法选取2013-2016年山东省内9个项目点的目标人群,年龄40~69岁,对符合条件的受检者采用内镜下碘染色观察和指示性活检技术进行筛查;对筛查结果进行分析,计算检出率、早诊率等,并进行统计检验。结果 9个项目点共完成筛查107 431人次,检出重度异型增生及以上病例1 093例,检出率为1.02%,其中早期病例941例,早诊率为86.09%;食管各级病变例数大致呈"金字塔"型分布,筛查可发现大量癌前病变和早期食管癌患者;社会性筛查带动了项目点食管癌诊治水平的提高,但不同地区间的检出率差异较大(P0.05),食管癌检出率与当地发病率密切相关;与机会性筛查相比,食管癌社会性筛查具有"检出率低、早诊率高"的特点。结论食管癌社会性筛查具有良好的社会效益,应继续推广;推动"社会性筛查"和"机会性筛查"融合发展以及"补需方"和"补供方"的有机结合,有利于提高检出率和早诊率,促进筛查工作的可持续发展。
[Abstract]:Objective Shandong Province began to undertake the early diagnosis and treatment of esophageal cancer in 2006, and achieved good social benefits. The purpose of this study was to analyze the screening results of early diagnosis and treatment of esophageal cancer in Shandong Province from 2013 to 2016 and to explore the improved strategies for esophageal cancer screening. Methods A cluster random sampling method was used to select the target population aged 4069 years from 2013 to 2016 in 9 project sites in Shandong province. The eligible subjects were screened by endoscopic iodine staining and indicative biopsy. The results of screening were analyzed, the detection rate and early diagnosis rate were calculated, and statistical tests were carried out. Results 107,431 people were screened in 9 project sites, 1093 cases of severe dysplasia and above were detected, the detection rate was 1.02. Among them, 941 cases were early cases, and the early diagnosis rate was 86.09%. The number of cases of esophageal lesions at all levels was "pyramid" distribution, screening can find a large number of precancerous lesions and early esophageal cancer patients; Social screening led to the improvement of diagnosis and treatment level of esophageal cancer, but the detection rate of esophageal cancer was significantly different among different regions (P0.05). The detection rate of esophageal cancer was closely related to the local incidence. Compared with opportunistic screening, social screening of esophageal cancer has the characteristics of low detection rate and high early diagnosis rate. Conclusion the social screening of esophageal cancer has good social benefits and should continue to be popularized. The combination of "social screening" and "opportunistic screening" and the organic combination of "supplementary demand side" and "supplementary supply side" will help to improve the detection rate and early diagnosis rate and promote the sustainable development of screening work.
【作者单位】：山东大学附属山东省肿瘤医院科教部山东省医学科学院;山东大学公共卫生学院;
【基金】：中央财政转移支付项目(2006BA102A15) 山东省科技发展计划(2014GSF118022)
【分类号】：R735.1

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