CAJ | 학술논문

目的：通过在城市人群中开展肺癌、乳腺癌、大肠癌、上消化道癌和肝癌等常见癌症高危人群的评估、筛查和早诊早治工作，探索早诊早治适宜技术，努力遏制城市癌症高发的势头。方法按照国家癌症中心统一制定的高危人群评估问卷对长沙市5个辖区的40~69岁常住居民开展问卷调查，并录入高危评估软件进行癌症高危评估，对评估为癌症的高危人群采用低剂量螺旋CT、乳腺超声、乳腺钼靶，腔镜（胃镜、肠镜）、指示性病例活检、AFP及肝脏超声检查等技术开展相应的癌症筛查。结果实施癌症高危人群评估50000人，共开展高危人群癌症筛查10136人次，其中肺部、肝脏、乳腺、上消化道（食管和胃）、大肠分别筛查3220人次、3109人次、2057人次、1018人次、732人次。筛查出癌前病变1279例，癌前病变阳性率为12.62%；检出可疑癌症患者47例，癌症筛查阳性率为0.46%。其中肺部癌前病变902例，阳性率为28.01%，癌变15例，阳性率为0.47%；肝脏癌前病变4例，阳性率为0.13%，癌变9例，阳性率为0.29%；乳腺癌癌前病变244例，阳性率为11.86%，癌变16例，阳性率为0.78%；上消化道癌癌前病变23例，阳性率为2.26%，癌变2例，阳性率为0.20%；大肠癌癌前病变106例，阳性率为14.48%，癌变5例，阳性率为0.68%。结论开展癌症早诊早治工作，能有效探索癌症防控新技术、新机制，有利于早期发现癌症，提高患者的早期诊治率、生存率和生存质量，降低癌症发病率。
목적：통과재성시인군중개전폐암、유선암、대장암、상소화도암화간암등상견암증고위인군적평고、사사화조진조치공작，탐색조진조치괄의기술，노력알제성시암증고발적세두。방법안조국가암증중심통일제정적고위인군평고문권대장사시5개할구적40~69세상주거민개전문권조사，병록입고위평고연건진행암증고위평고，대평고위암증적고위인군채용저제량라선CT、유선초성、유선목파，강경（위경、장경）、지시성병례활검、AFP급간장초성검사등기술개전상응적암증사사。결과실시암증고위인군평고50000인，공개전고위인군암증사사10136인차，기중폐부、간장、유선、상소화도（식관화위）、대장분별사사3220인차、3109인차、2057인차、1018인차、732인차。사사출암전병변1279례，암전병변양성솔위12.62%；검출가의암증환자47례，암증사사양성솔위0.46%。기중폐부암전병변902례，양성솔위28.01%，암변15례，양성솔위0.47%；간장암전병변4례，양성솔위0.13%，암변9례，양성솔위0.29%；유선암암전병변244례，양성솔위11.86%，암변16례，양성솔위0.78%；상소화도암암전병변23례，양성솔위2.26%，암변2례，양성솔위0.20%；대장암암전병변106례，양성솔위14.48%，암변5례，양성솔위0.68%。결론개전암증조진조치공작，능유효탐색암증방공신기술、신궤제，유리우조기발현암증，제고환자적조기진치솔、생존솔화생존질량，강저암증발병솔。
Objective To examine whether early cancer diagnosis and treatment can help reduce the increasing incidence of cancer in cities,we evaluated the results of a survey in Changsha,China concerning the detection and treatment of common cancers of the lung,breast,colon,upper gastrointestinal tract and liver. Methods A survey of residents aged 40-69 years in five districts of Changsha was conducted in 2012-2013 to identify high-risk cancer populations,and individuals assessed to be at high risk of one or more cancers were screened using low-dose spiral CT,breast and liver ultrasound,mammary molybdenum target,or endoscopy as appropriate. Results The implementation of high-risk assessment included 50 000 people and the cancer screening included 10 136 person-time;this investment varied by target organ as follows: lung,3 220 person-time;liver,3 109 person-time;breast,2 057 person-time;esophagus and stomach,1 018 person-time;large intestine,732 person-time.Precancerosis was detected in 1 279 cases,and the positive rate was 12.62%. A total of 47 suspected cancer patients were screened,and the positive rate was 0.46%. Precancerosis and cancer showed different prevalences by tissue type:precancerous lung lesions were found in 902 individuals,and the positive rate was 28.01%;lung cancer was found in 15 cases,and the positive rate was 0.47%;precancerous liver lesions were found in 4 cases,and the positive rate was 0.13%;liver cancer was found in 9 cases,and the positive rate was 0.29%;precancerous large intestine lesions were found in 106 cases,and the positive rate was 14.48%;colorectal cancer was found in 5 cases,and the positive rate was 0.68%;precancerous upper gastrointestinal tract lesions were found in 23 cases,and the positive rate was 2.26%;upper gastrointestinal tract cancer was found in 2 cases,and the positive rate was 0.20%;precancerous breast lesions were found in 244 cases,and the positive rate was 11.86%;and breast cancer was found in 16 cases,and the positive rate was 0.78%. Conclusions Targeted efforts to screen for and diagnose cancer early in cities can be an effective way to increase the rate of early treatment,survival and quality of life.