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2020-2021年上消化道癌机会性和门诊及人群筛查结果比较 被引量:3

Comparison of outpatient,population-based and opportunistic screening outcomes for upper gastrointestinal cancer from 2020to 2021
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摘要 目的探讨上消化道癌普通门诊、人群筛查与机会性筛查模式下筛查结果的差异,明确机会性筛查在上消化道疾病检测中的意义。方法选取2020-01-01-2021-12-31在扬中市人民医院行普通门诊、机会性和人群筛查的30701人的上消化道筛查资料,其中男14727人,女15974人。分析不同模式下的人群特征、筛查技术和结果,采用检出率差异(PPD)和检出率比(PPR)探讨疾病检出率的组间差异,并按性别和年龄进行分层分析。结果纳入者中,普通门诊、机会性筛查和人群筛查分别为13089(42.63%)、13544(44.12%)和4068(13.25%)人,平均年龄分别为(52.95±14.29)、(55.49±10.71)和(56.47±7.12)岁。与人群筛查相比,机会性筛查检出轻-中度萎缩性胃炎/肠化(PPD为-16.73%,95%CI:-18.31%~-15.15%;PPR为0.497,95%CI:0.470~0.527)、重度萎缩性胃炎/肠化(PPD为-1.59%,95%CI:-2.12%~-1.07%;PPR为0.395,95%CI:0.308~0.507)、低级别上皮内瘤变(PPD为-1.01%,95%CI:-1.72%~-0.29%;PPR为0.734,95%CI:0.621~0.867)和高级别上皮内瘤变(PPD为-0.19%,95%CI:-0.47%~0.08%;PPR为0.555,95%CI:0.347~0.888)的比例较低,但检出阳性病例(PPD为1.52%,95%CI:1.10%~1.93%;PPR为1.701,95%CI:1.238~2.337)的比例较高且以中晚期癌症(PPD为1.62%,95CI:1.35%~1.89%;PPR为5.647,95%CI:2.891~11.028)为主。与普通门诊相比,除高级别上皮内瘤变外,机会性筛查相应疾病PPD和PPR分布特征均与上述相反,均P<0.05。此外,机会性筛查(29.26%)和普通门诊(34.53%)的早诊率均低于人群筛查(79.55%)。分层分析显示,在不同性别和年龄组人群中发现了与全人群类似的检出率差异。结论与人群筛查相比,机会性筛查具有阳性病例检出率高、癌前疾病/病变检出率低、早诊率低的特点,但癌前疾病、低级别上皮内瘤变和中晚期癌检出率要优于普通门诊。机会性筛查可以作为重要补充,覆盖未参与人群筛查的高危人群。基层医疗机构应充分认识机会性筛查在癌症防治中的� Objective To explore the differences in screening results between general outpatient,population-based,and opportunistic screenings for upper gastrointestinal cancers and to clarify the significance of opportunistic screening in detecting upper gastrointestinal diseases.Methods Information on 30701upper gastrointestinal screenings of 14727males and 15974females who performed general outpatient,opportunistic and population-based screening at People's Hospital of Yangzhong City from 2020-01-01to 2021-12-31was selected.Population characteristics,screening techniques and results across modalities were analyzed.The difference of disease detection rate between groups was discussed by differences in prevalence proportion(PPD)and prevalence proportion ratios(PPR),and stratifying analysis was conducted by gender and age.Results Of those included,13089(42.63%),13544(44.12%)and 4068(13.25%)were included for general outpatient,opportunistic and population-based screening,aged(52.95±14.29),(55.49±10.71)and(56.47±7.12)years,respectively.Compared to population-based screening,opportunistic screening detected lower rates in mild to moderate atrophic gastritis/intestinal metaplasia(PPD:-16.73%,95%CI:-18.31%--15.15%;PPR:0.497,95%CI:0.470-0.527),severe atrophic gastritis/intestinal metaplasia(PPD:-1.59%,95%CI:-2.12%--1.07%;PPR:0.395,95%CI:0.308-0.507),low-grade intraepithelial neoplasia(PPD:-1.01%,95%CI:-1.72%--0.29%;PPR:0.734,95%CI:0.621-0.867)and high-grade intraepithelial neoplasia(PPD:-0.19%,95%CI:-0.47%-0.08%;PPR:0.555,95%CI:0.347-0.888),but a higher proportion of positive cases(PPD:1.52%,95%CI:1.10%-1.93%;PPR:1.701,95%CI:1.238-2.337)were detected and were predominantly intermediate to advanced cancers(PPD:1.62%,95%CI:1.35%-1.89%;PPR:5.647,95%CI:2.891-11.028).Compared with the general outpatient,the distribution characteristics of PPD and PPR for the corresponding diseases in opportunistic screening were opposite to those described above,except for high-grade intraepithelial neoplasia(all P<0.05).In addition,early detection
作者 冯祥 印红军 华召来 施秋平 夏林 周金意 朱进华 FENG Xiang;YIN Hongjun;HUA Zhaolai;SHI Qiuping;XIA Lin;ZHOU Jinyi;ZHU Jinhua(People's Hospital of Yangzhong City,Yangzhong212200,China;Department of Non-communicable Disease Prevention,Jiangsu Center for Disease Control and Prevention,Nanjing210009,China;Department of Gastroenterology,Zhongda Hospital Affiliated to Southeast University,Nanjing210000,China;Medical College,Southeastern University,Nanjing210000,China)
出处 《中华肿瘤防治杂志》 CAS 北大核心 2023年第8期443-449,共7页 Chinese Journal of Cancer Prevention and Treatment
基金 国家重点研发计划(2016YFC0901400,2016YFC1302800) 中国消化道早癌医师共同成长计划(GTCZ-2021-JS-32-0001) 镇江市重点研发计划-社会发展(SH2022051) 扬中市重点研发计划(YS202005)。
关键词 上消化道癌 机会性筛查 人群筛查 检出率 upper gastrointestinal cancer opportunistic screening population-based screening detection rate
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