CAJ | 학술논문

目的比较大肠癌筛查在农村高发地区高危人群中的病变年龄别检出率,为大肠癌筛查目标人群起始年龄的确定提供依据.方法对应用大肠癌优化序贯筛查方案检出的结直肠病变进行统计和分析,计算结直肠癌及各种腺瘤的年龄别检出率和构成比.结果现场应用优化序贯筛查方案后,8867人完成结肠镜检查者中,检出结直肠病变1811例,检出率为20.42％.其中检出结直肠癌92例,检出率为1.04％;检出结直肠腺瘤1164例,检出率为13.13％,其中进展期结直肠腺瘤377例,检出率为4.25％.40～44岁年龄组结直肠病变的检出率均低于45～49岁年龄组.如果剔除40～44岁年龄组,结直肠病变的检出率可提高7.84％,结直肠癌的检出率提高13.46％,结直肠腺瘤的检出率提高8.76％,进展期结直肠腺瘤的检出率提高12.24％,初筛成本可降低19.64％,结肠镜检查成本可降低13.30％.结论在40～74岁的高危人群中,结直肠癌和结直肠腺瘤的年龄别检出率随着受检者年龄的增加而升高;40 ～44岁年龄组结直肠癌和结直肠腺瘤的检出率及构成比明显低于其他年龄组;我国农村地区大肠癌筛查目标人群起始年龄提高5岁是可行的.
목적 비교대장암사사재농촌고발지구고위인군중적병변년령별검출솔,위대장암사사목표인군기시년령적학정제공의거.방법 대응용대장암우화서관사사방안검출적결직장병변진행통계화분석,계산결직장암급각충선류적년령별검출솔화구성비.결과 현장응용우화서관사사방안후,8867인완성결장경검사자중,검출결직장병변1811례,검출솔위20.42％.기중검출결직장암92례,검출솔위1.04％;검출결직장선류1164례,검출솔위13.13％,기중진전기결직장선류377례,검출솔위4.25％.40～44세년령조결직장병변적검출솔균저우45～49세년령조.여과척제40～44세년령조,결직장병변적검출솔가제고7.84％,결직장암적검출솔제고13.46％,결직장선류적검출솔제고8.76％,진전기결직장선류적검출솔제고12.24％,초사성본가강저19.64％,결장경검사성본가강저13.30％.결론 재40～74세적고위인군중,결직장암화결직장선류적년령별검출솔수착수검자년령적증가이승고;40 ～44세년령조결직장암화결직장선류적검출솔급구성비명현저우기타년령조;아국농촌지구대장암사사목표인군기시년령제고5세시가행적.
Objective To compare the age-specific detection rates of colorectal neoplasms by colonoscopic screening among high-risk population in rural area and to provide evidence for determining the initial age in the colorectal cancer screening.Methods The age-specific detection rates of colorectal cancers and adenomas,and the proportion of detected cases in each age group after screening by the optimized sequential colorectal cancer screening program in Jiashan County,Zhejiang Province,were analyzed.Results Mass screening with the optimized sequential colorectal cancer screening program in Jiashan was conducted and 8867 colonoscopic examinations were performed.A total of 1811 individuals with at least one colorectal neoplastic lesion were found.Among them,there were 92 (1.04％) colorectal cancer patients,1164 (13.13％) patients with at least one adenoma and 377 (4.25％) patients with at least one advanced adenoma.The detection rate of colorectal neoplastic lesions for the age group 40-44 was considerably lower than that in the age group 45-49.Hypothetically,to increase the initial age to 45-years for the optimized sequential colorectal cancer screening program would yield a 7.84％ increase in the detection rate of total colorectal neoplastic lesions,13.46％ increase in the detection rate of colorectal cancer,8.76％ increase in the detection rate of adenoma,12.24％ increase in the detection rate of advanced adenoma and 19.64％ lower in the cost of initial screening,13.30％ lower in the cost of colonoscopic screening.Conclusions Among the high-risk population aged 40 to 74,the detection rates of colorectal cancer and adenoma are increasing with the increase of age,the detection rates of colorectal cancer and adenoma as well as proportion of detected cases in the 40-44 age group are considerably lower.To increase the initial age to 45 for colorectal cancer screening in rural area of China is reasonable.