[目的]分析2015~2018年云南省昆明市城市癌症早诊早治项目上消化道癌筛查结果。[方法]在40~74岁昆明市居民中,采用问卷调查评估出上消化道癌高危人群;经知情同意后进行胃镜检查及活检病理诊断,并对筛查结果进行分析。[结果] 95 296人完成上消化道癌危险因素评估,高风险25 300人,高风险率为26.55%。实际完成临床筛查6158人,依从性24.34%;其中女性依从性(26.67%)高于男性(20.66%),50~59岁年龄组的依从性最高(26.75%),各年龄组差异有统计学意义(P<0.05)。纳入胃镜及病理诊断筛查结果分析共5068例。胃镜下食管病变阳性率为5.76%;胃炎检出率为89.27%,胃及十二指肠溃疡检出率为7.44%,胃息肉为6.02%,胃黏膜病变为1.42%。病理诊断食管癌前病变检出率为1.07%,食管癌检出率为0.04%;胃癌前病变检出率为4.06%,胃癌及其他恶性肿瘤为0.06%。不同性别及不同年龄组中,食管癌前病变和食管癌检出率均无差异(P>0.05)。不同性别胃癌前病变检出无差异(P>0.05),60~69岁和70岁以上年龄组胃癌前病检检出率高于40~49岁和50~59岁年龄组(P=0.003)。[结论]以问卷调查评估为基础,结合胃镜及病理诊断,能提高早期发现、早期诊断和早期治疗的比例,降低上消化道癌发病率和死亡率,提高患者生活质量,减轻个人和社会经济负担。
[Purpose]To analyze the results of screening for upper gastrointestinal cancer in Kunming City from 2015 to 2018.[Methods]Upper gastrointestinal cancer screening program was conducted among residents aged 40~74 years old in Kunming City from 2015 to 2018.The risk factors were surveyed by questionnaires,and gastroscopy,biopsy and pathological diagnosis were performed for the participants with high risk.The screening results were analyzed.[Results]A total of 95 296 residents completed the assessment of risk factors for upper digestive tract cancer,and 25 300 subjects(26.55%)with high risk were identified.Among them 6158 participants(24.34%)completed the gastroscopic examination,the compliance rate of gastroscopy in females was higher than that in males(26.67%vs 20.66%).and that in age group 50~59 years was the highest(26.75%,P<0.05).Finally 5068 cases were completed endoscopy and pathological diagnosis.The positive rate of esophageal lesions was 5.76%;the detection rate of gastritis was 89.27%,and the gastric and duodenal ulcer was 7.44%;the rate of gastric polyp was 6.02%,and gastric mucosal lesions was 1.42%.The positive rate of esophageal precancerous lesions with pathological diagnosis was 1.07%,and the detection rate of esophageal cancer was 0.04%.The detection rate of gastric precancerous lesions was 4.06%,and gastric cancer or other malignant tumors was 0.06%.There was no difference in the prevalence of esophageal precancerous lesions and esophageal cancer between different genders and age groups(P>0.05).There was also no difference in the detection of precancerous gastric lesions in different genders(P>0.05).The prevalence of precancerous gastric lesions in age group 60~69 was higher than that in age groups 40~49 and 50~59(P=0.003).[Conclusion]The screening based on combined questionnaire survey,risk assessment,gastroscopy and pathological diagnosis,the early detection,early diagnosis and early treatment of upper gatrointestinal cancer can be improved.
Bulletin of Chinese Cancer