中國結(jié)直腸癌篩查實(shí)踐方案

中國結(jié)直腸癌篩查實(shí)踐方案

urbanarea ruralareaorgan 19912000increase(%)19912000increase(%)all 123.92 146.6118.31101.39112.5711.03lung32.5342.0829.3814.2921.1147.73liver19.3622.1913.0422.2526.0617.12stomach19.6919.941.2722.5520.94-7.14colon/rectum8.5311.1931.185.146.0417.51oesophagus8.949.061.3416.3215.24-6.62breast3.114.3238.911.512.1139.73leukemia3.603.826.113.313.18-3.93nasopharynx2.172.14-1.381.701.784.72cervix1.491.08-27.522.311.91-17.32baldder1.832.2623.500.891.1119.82中國局部地區(qū)1991-2000癌癥死亡率(1/100000)ChinaOncology2002;(11)5DistributionofCRC

highincidenceareainChinaRedrepresentshighincidenceareaDatain1970s

中國結(jié)直腸癌篩查工程國家“十一五科技支撐方案〞(2006-2021)國家科學(xué)技術(shù)部癌癥早診早治工程(2006-2021)國家衛(wèi)生部．癌癥基金會(huì)中國結(jié)直腸癌篩查流程圖QuestionnairesurveyiFOBT(+)(+)158926106412140348531750(8.8%)763(8.9%)57(0.7%)35(0.4%)Age40-74,invitedtoscreenCompletequestionnaireandFOBTQuestionnaire(+)orFOBT(+)Completecolonoscopy腺瘤其它息肉早期癌進(jìn)展期癌初篩順應(yīng)性67%結(jié)腸鏡順應(yīng)性61%陽性率13.2%1605ColorectalNeoplasm陽性率

18.8%都市:上海，哈爾濱，杭州鄉(xiāng)村：海寧縣，嘉善縣QS&FOBT奉獻(xiàn)腺瘤Ques(+)465(61%)457(61%)19(21%)941(59%)FOBT(+)245(32%)225(30%)50(54%)520(32%)Both(+)53(7%)68(9%)23(25%)144(9%)all763750921605其它息肉癌all61%adenomawerediscoveredbyQuestionnairebutmissedbyFOBT中國城市和鄉(xiāng)村的篩查順應(yīng)性ComplianceforfirstscreenComplianceforcolonoscopyHighriskindividualsHaining89.8%79.6%16.5%Jiashan88.9%78.0%12.6%Hz,Hb,Sh45.6%34.8%13.3%ScreencomplianceincountiesismuchbetterthanthatinlargecitiesRuralareaUrbanareaDatain20210.000.100.200.300.400.500.600.700.800.901.0001234567screeningcontrol

AccumulationmortalityforcoloncancerinJiashanCountyyearsZhengs,zhangsz,Discolonrectum,2003,46：51-58

AccumulationmortalityforrectalcancerinJiashanCounty

31.7%YearsZhengs,zhangsz,Discolonrectum,2003,46：51-58

Zhengs,Zhangsz,Discolonrectum,2003,46：51-58現(xiàn)行方案

40－74歲個(gè)體,問卷：

(1)一級(jí)親屬大腸癌史

(2)本人有癌癥史

(3)本人腸息肉史

(4)具有以下二項(xiàng)及二項(xiàng)以上者: ①慢性腹瀉；②粘液血便；③慢性便秘；④慢性闌尾炎；⑤精神刺激史；⑥慢性膽道疾病史。大便潛血２iFOBT,1周間隔全結(jié)腸鏡問卷或ＦＯＢＴ陽性推薦全結(jié)腸鏡檢查y

CRCS