目的:天津市实施结直肠癌筛查,自2012年中国。目的是按年龄和性别评估高危人群中肿瘤形成的检出率,并研究与结直肠肿瘤形成相关的潜在因素。
方法:本研究基于2012-2020年天津市CRC筛查计划的数据。高风险因素问卷(HRFQ)阳性或粪便免疫化学测试(FIT)阳性的居民被确定为高风险参与者,随后被建议进行免费结肠镜检查。
结果:共有4,117,897名40-74岁的合格参与者完成了HRFQ和FIT,其中217,164人(5.3%)被确定为高危参与者.初步筛查的阳性率随年龄增长而增加,女性高于男性。对于进行结肠镜检查的57,971名参与者,非晚期腺瘤的检出率,晚期腺瘤和CRC为37.8%,5.7%和1.6%,分别。晚期肿瘤的检出率从50岁开始增加,男性更高。对于非晚期肿瘤,从40岁开始的男性和50岁开始的女性中观察到了强劲的增长。男性对40-49岁的个体的影响大于对老年人的影响。几个因素,包括目前的吸烟,饮酒,较高的体重指数(BMI)与肿瘤的存在显着相关,然而,这些协会主要限于50岁以上的个人,但不限于40-49岁的个人。
结论:这些发现支持应推荐年龄特异性风险分层和性别特异性开始年龄进行CRC筛查,以提高当前筛查策略的准确性和有效性。
OBJECTIVE: Colorectal cancer (CRC) screening has been implemented in Tianjin,
China since 2012. The objective was to estimate the neoplasia detection rate in a high-risk population by age and sex and to investigate the potential factors associated with colorectal neoplasia.
METHODS: This study is based on data of the Tianjin CRC screening program from 2012 to 2020. Residents with a positive high-risk factors questionnaire (HRFQ) or a positive faecal immunochemical test (FIT) were identified as high-risk participants and were subsequently recommended for a free colonoscopy.
RESULTS: A total of 4,117,897 eligible participants aged 40-74 years completed both a HRFQ and FIT, and 217,164 (5.3%) of them were identified as high-risk participants. Positive rates of preliminary screening increased with age and were higher in females than in males. For 57,971 participants undertaking colonoscopy, the detection rates of nonadvanced adenoma, advanced adenoma and CRC were 37.8%, 5.7% and 1.6%, respectively. Detection rates of advanced neoplasia increased from the age of 50 and were higher in males. For nonadvanced neoplasia, a strong increase was observed in males from the age of 40 and in females from the age of 50. Male sex had a greater impact on individuals aged 40-49 than on older individuals. Several factors including current smoking, drinking, and higher body mass index (BMI) were significantly associated with the presence of neoplasia, whereas, these associations were mainly restricted to individuals aged above 50 but not those aged 40-49 years.
CONCLUSIONS: These findings support that age-specific risk stratification and sex-specific initiating ages for CRC screening should be recommended to improve the accuracy and effectiveness of current screening strategy.