【摘要】：目的山東省自2006年開始承擔(dān)國家食管癌早診早治項(xiàng)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(xiàng)目篩查結(jié)果,探討食管癌篩查的改進(jìn)策略。方法采用整群隨機(jī)抽樣法選取2013-2016年山東省內(nèi)9個項(xiàng)目點(diǎn)的目標(biāo)人群,年齡40~69歲,對符合條件的受檢者采用內(nèi)鏡下碘染色觀察和指示性活檢技術(shù)進(jìn)行篩查;對篩查結(jié)果進(jìn)行分析,計(jì)算檢出率、早診率等,并進(jìn)行統(tǒng)計(jì)檢驗(yàn)。結(jié)果 9個項(xiàng)目點(diǎn)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(xiàng)目點(diǎn)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(dāng)?shù)匕l(fā)病率密切相關(guān);與機(jī)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(diǎn)。結(jié)論食管癌社會性篩查具有良好的社會效益,應(yīng)繼續(xù)推廣;推動"社會性篩查"和"機(jī)會性篩查"融合發(fā)展以及"補(bǔ)需方"和"補(bǔ)供方"的有機(jī)結(jié)合,有利于提高檢出率和早診率,促進(jìn)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(xué)附屬山東省腫瘤醫(yī)院科教部山東省醫(yī)學(xué)科學(xué)院;山東大學(xué)公共衛(wèi)生學(xué)院;
【基金】：中央財(cái)政轉(zhuǎn)移支付項(xiàng)目(2006BA102A15) 山東省科技發(fā)展計(jì)劃(2014GSF118022)
【分類號】：R735.1

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