中国结直肠癌筛查实践的方案PPT课件

FOBT(+) 245(32%) 225(30%) 50(54%) 520(32%)
Both(+) 53(7%)
68(9%) 23(25%) 144(9%)
all
763
750
92
1605
61% adenoma were discovered by Questionnaire but
missed by FOBT
18.31 29.38 13.04 1.27 31.18
1.34 38.91 6.11 -1.38 -27.52 23.50
101.39 14.29 22.25 22.55
5.14 16.32 1.51 3.31
1.70 2.31 0.89
112.57 21.11 26.06 20.94 6.04 15.24 2.11 3.18
中国结直肠癌筛查实践 方案
1
中国部分地区1991-2000 癌症死亡率(1/100 000)
organ
1991
urban area 2000 increase(%)
1991
rural area 2000 increase(%)
all
123.92
lung
32.53
liver
19.36
stomach 19.69
1.78 1.91 1.11
11.03 47.73 17.12 -7.14 17.51 -6.62 39.73
-3.93 4.72 -17.32 19.82
China Oncology 2019;(121)5
Distribution of CRC high incidence area in China
0.50
0.40
0.30
0.20
0.10
0.00
01234567
years
Accumulation mortality for colon cancer in Jiashan County
Zhengs,zhangsz, Dis colon rectum,2019, 46：951-58
1.80 1.60 1.40
14034
结肠镜顺应性 61%
阳性率 18.8%
8531 1605
Complete colonoscopy Colorectal Neoplasm
750(8.8%)
其它息肉
763(8.9%)
腺瘤
57(0.7%)
早期癌
35(0.4%)
进展期癌6
QS & FOBT贡献
腺瘤
其它息肉 癌
all
Ques(+) 465(61%) 457(61%) 19(21%) 941(59%)
Screening control
1.20
1.00
0.80
0.60
0.40
0.20
0.00
0
1
2
3
4
5
6
7
Years
Accumulation mortality for rectal cancer in Jiashan County 31.7%
Zhengs,Zhangsz, Dis colon rectum,2019, 46：51-58
7
中国城市和乡村的筛查顺应性
Compliance Compliance for High risk for first screen colonoscopy individuals
Rural area
Haining Jiashan
89.8% 88.9%
79.6% 78.0%
16.5% 12.6%
Urban
Zhengs,zhangsz, Dis colon rectum,2019, 46：1051-58
现行方案
40－74岁个体,
问卷：
(1)一级亲属大肠癌史
(2)本人有癌症史
(3) 本人肠息肉史
(4) 具有以下二项及二项以上者:
① 慢性腹泻；② 粘液血便；③ 慢性便秘；④ 慢性阑
尾炎； ⑤ 精神刺激史；⑥ 慢性胆道疾病史。
大便潜血
２ iFOBT, 1 周间隔
全结肠镜 问卷或ＦＯＢＴ阳性推荐全结肠镜检查y
11
CRC Screeing Program in China 2019
Red represents high incidence area
Ninxia 1 Beijing 1
Tianjin 1
Sanxi 1
Sandong 1
colon/rectum 8.53
oesophagus 8.94
breast
3.11
leukemia 3.60
nasopharynx 2.17
cervix
1.49
baldder 1.83
146.61 42.08 22.19 19.94 11.19
9.06 4.32 3.82 2.14 1.08 2.26
Red represents high incidence area
Data in 1970s
3
中国结直肠癌筛查项目
国家“十一五科技支撑计划”(2019-2009)
国家科学技术部
癌症早诊早治项目(2019-2019) 国家卫生部．癌症基金会
4
中国结直肠癌筛查流程图
Questionnaire survey (+)
iFOBT (+)
5
都市: 上海，哈尔滨，杭州
乡村：海宁县，嘉善县
158926
初筛顺ቤተ መጻሕፍቲ ባይዱ性 67%
Age 40-74, invited to screen Complete questionnaire and FOBT
106412
阳性率 13.2%
Questionnaire(+) or FOBT(+)
Hubei 2
Yunnan 1 Sichuan 1
Shanghai 1 Zhejiang 2
Guangdong 1
12
谢谢您
13
area Hz,Hb,Sh
45.6%
34.8%
13.3%
Screen compliance in counties is much better than that in large cities
Data in 2019
8
1.00
0.90 0.80 0.70
screening
control
0.60