【摘要】：目的山東省自2006年開始承擔國家食管癌早診早治項目,取得了良好的社會效益。本研究旨在分析山東省2013-2016年食管癌早診早治項目篩查結果,探討食管癌篩查的改進策略。方法采用整群隨機抽樣法選取2013-2016年山東省內9個項目點的目標人群,年齡40~69歲,對符合條件的受檢者采用內鏡下碘染色觀察和指示性活檢技術進行篩查;對篩查結果進行分析,計算檢出率、早診率等,并進行統(tǒng)計檢驗。結果 9個項目點共完成篩查107 431人次,檢出重度異型增生及以上病例1 093例,檢出率為1.02%,其中早期病例941例,早診率為86.09%;食管各級病變例數(shù)大致呈"金字塔"型分布,篩查可發(fā)現(xiàn)大量癌前病變和早期食管癌患者;社會性篩查帶動了項目點食管癌診治水平的提高,但不同地區(qū)間的檢出率差異較大(P0.05),食管癌檢出率與當?shù)匕l(fā)病率密切相關;與機會性篩查相比,食管癌社會性篩查具有"檢出率低、早診率高"的特點。結論食管癌社會性篩查具有良好的社會效益,應繼續(xù)推廣;推動"社會性篩查"和"機會性篩查"融合發(fā)展以及"補需方"和"補供方"的有機結合,有利于提高檢出率和早診率,促進篩查工作的可持續(xù)發(fā)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.
【作者單位】： 山東大學附屬山東省腫瘤醫(yī)院科教部山東省醫(yī)學科學院;山東大學公共衛(wèi)生學院;
【基金】：中央財政轉移支付項目(2006BA102A15) 山東省科技發(fā)展計劃(2014GSF118022)
【分類號】：R735.1

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