中国结直肠癌筛查实践的方案

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, 46：51-58
1.80 1.60 1.40
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
1.00
0.90 0.80 0.70
screening
control
0.60
0.50
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
QS & FOBT贡献
腺瘤
其它息肉 癌
all
Ques(+) 465(61%) 457(61%) 19(21%) 941(59%)
Zhengs,zhangsz, Dis colon rectum,2019, 46：51-58
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。
Data in 1970s
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
中国结直肠癌筛查流程图
Questionnaire survey (+)
iFOBT (+)
都市: 上海，哈尔滨，杭州
乡村：海宁县，嘉善县
158926 Age 40-74, invited to screen
初筛顺应性 67%
Complete questionnaire and FOBT
106412
阳性率 13.2%
Questionnaire(+) or FOBT(+)
14034
结肠镜顺应性 61%
阳wk.baidu.com率 18.8%
8531 1605
nasopharynx 2.17
cervix
1.49
baldder 1.83
urban area
2000 increase(%)
146.61
18.31
42.08 22.19 19.94 11.19 9.06 4.32 3.82
2.14 1.08 2.26
29.38 13.04 1.27 31.18 1.34 38.91 6.11 -1.38 -27.52 23.50
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
47.73 17.12 -7.14 17.51 -6.62 39.73 -3.93 4.72 -17.32 19.82
China Oncology 2019;(11)5
Distribution of CRC high incidence area in China
Red represents high incidence area
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
1991
101.39 14.29 22.25 22.55
5.14 16.32 1.51 3.31
1.70 2.31 0.89
rural area
2000 increase(%)
112.57 11.03
21.11 26.06 20.94 6.04 15.24 2.11 3.18 1.78 1.91 1.11
Hubei 2
Yunnan 1 Sichuan 1
Shanghai 1 Zhejiang 2
Guangdong 1
谢谢您
中国结直肠癌筛查实践 方案
中国部分地区1991-2000 癌症死亡率(1/100 000)
organ 1991
all
123.92
lung
32.53
liver
19.36
stomach 19.69
colon/rectum 8.53
oesophagus 8.94
breast
3.11
leukemia 3.60
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
CRC Screeing Program in China 2019
Red represents high incidence area
Ninxia 1 Beijing 1
Tianjin 1
Sanxi 1
Sandong 1
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