2013～2018年浙江省宁波市城市居民肺癌风险评估及筛查结果分析
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摘要
[目的]分析浙江省宁波市2013～2018年城市居民肺癌风险评估及筛查结果,为肺癌早诊早治工作提供依据。[方法]根据城市癌症早诊早治项目技术方案,在宁波市选取海曙区、江北区、鄞州区作为项目点,通过癌症危险因素问卷调查和风险评估,评出的高风险对象免费接受低剂量螺旋CT检查,分析肺癌的高风险率、筛查率和检出率。[结果]共完成问卷调查和风险评估77 061例,评出肺癌高风险对象14 752例(高风险率为19.14%),完成低剂量螺旋CT检查8876例(筛查率为60.17%),检出阳性结节1237例(检出率为13.94%)、<5mm实性/部分实性结节3848例(检出率为43.35%)、<8mm非实性结节370例(检出率为4.17%)、疑似肺癌134例(检出率为1.51%),通过随访,病理确诊肺癌44例,早诊率86.36%。[结论]要在重点人群中开展肺癌风险评估和高危人群筛查,探索更精准的肺癌高危人群评估方法,以提高筛查和早诊早治效果,同时应加强肺癌防控科普宣传,以提高居民的癌症筛查意识。
[Purpose] To analyze the results of lung cancer screening with risk assessment and CT scanning among urban residents in Ningbo City. [Methods] The lung cancer screening program was conducted in 3 urban districts(Haishu,Jiangbei and Yinzhou) of Ningbo City from 2013 to 2018. The risk of lung cancer was assessed with questionnaire survey,and the high-risk subjects were identified for further low-dose spiral CT examination. The high-risk rate,CT examination rate and lung cancer detection rate were analyzed. [Results] A total of 77 061 subjects completed with questionnaire survey and risk assessment,and 14 752 cases(19.14%) with high risk of lung cancer were identified,among who 8876 cases(60.17%) received low-dose spiral CT examination. Total1237 cases(13.94%) with positive nodules were detected,3848(43.35%) <5 mm solid/partial solid nodules and 370(4.17%) with <8 mm non-solid nodules were detected. Among 134 cases(1.51%) of suspected lung cancer,44 patients with lung cancer were confirmed by pathological examination,86.36% of whom were early lung cancer. [Conclusion] Risk assessment and CT screening for high-risk population of lung cancer is effective to detect early lung cancer,however,the methods for high-risk assessment need to be improved and the health education for lung cancer screening should be strengthened among urban residents.
[Purpose] To analyze the results of lung cancer screening with risk assessment and CT scanning among urban residents in Ningbo City. [Methods] The lung cancer screening program was conducted in 3 urban districts(Haishu,Jiangbei and Yinzhou) of Ningbo City from 2013 to 2018. The risk of lung cancer was assessed with questionnaire survey,and the high-risk subjects were identified for further low-dose spiral CT examination. The high-risk rate,CT examination rate and lung cancer detection rate were analyzed. [Results] A total of 77 061 subjects completed with questionnaire survey and risk assessment,and 14 752 cases(19.14%) with high risk of lung cancer were identified,among who 8876 cases(60.17%) received low-dose spiral CT examination. Total1237 cases(13.94%) with positive nodules were detected,3848(43.35%) <5 mm solid/partial solid nodules and 370(4.17%) with <8 mm non-solid nodules were detected. Among 134 cases(1.51%) of suspected lung cancer,44 patients with lung cancer were confirmed by pathological examination,86.36% of whom were early lung cancer. [Conclusion] Risk assessment and CT screening for high-risk population of lung cancer is effective to detect early lung cancer,however,the methods for high-risk assessment need to be improved and the health education for lung cancer screening should be strengthened among urban residents.
引文
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[13]Zhang N,Zhang X,Zhou QJ.Survey of lung cancer risk factors among residents over 65 years old in Shanghai community[J].China General Practice,2018,21(36):4489-4492.[张宁,张贤,周谦君.上海社区65岁以上居民肺癌危险因素现况调查[J].中国全科医学,2018,21(36):4489-4492.]
[14]Li H,Gong QH,Sun XH,et al.Risk assessment and clinical screening of malignant tumors among urban residents in Ningbo[J].Preventive Medicine,2017,29(10):1024-1026.[李辉,龚清海,孙校华,等.宁波市城市居民恶性肿瘤风险评估及临床筛查结果分析[J].预防医学,2017,29(10):1024-1026.]
[2]Chen WQ,Li H,Sun KX,et al.Analysis of the incidence and mortality of malignant tumors in China in 2014[J].Chinese Journal of Oncology,2018,40(1):5-13.[陈万青,李贺,孙可欣,等.2014年中国恶性肿瘤发病和死亡分析[J].中华肿瘤杂志,2018,40(1):5-13.]
[3]Mao WM.Annual report of Zhejiang cancer registration2015[M].Hangzhou:Zhejiang Science and Technology Publishing House,2016.[毛伟敏.2015浙江省肿瘤登记年报[M].杭州:浙江科学技术出版社,2016.]
[4]Disease Prevention and Control Bureau of the Ministry of Health of the People’s Republic of China.Technical program for early diagnosis and treatment of cancer(2011edition)[M].Beijing:People’s Health Publishing House,2011.[中华人民共和国卫生部疾病预防控制局.癌症早诊早治项目技术方案(2011年版)[M].北京:人民卫生出版社,2011.]
[5]Dai M,Shi JF,Li N.Project design and expected objectives for early diagnosis and treatment of cancer in Chinese cities[J].Chinese Journal of Preventive Medicine,2013,47(2):179-182.[代敏,石菊芳,李霓.中国城市癌症早诊早治项目设计及预期目标[J].中华预防医学杂志,2013,47(2):179-182.]
[6]National Cancer Center,Cancer Hospital of Chinese Academy of Medical Sciences.Technical program of urban cancer early diagnosis and treatment project(2018 Edition)[Z].Beijing:National Cancer Center,2018.[国家癌症中心,中国医学科学院肿瘤医院.城市癌症早诊早治项目技术方案(2018年版)[Z].北京:国家癌症中心,2018.]
[7]Li HZ,Du LB,Sun XH,et al.Report on the results of screening for early diagnosis and treatment of cancer among urban residents in Zhejiang Province[J].Zhejiang Preventive Medicine,2015,27(12):1189-1193.[李辉章,杜灵斌,孙校华,等.浙江省城市居民癌症早诊早治项目筛查结果报告[J].浙江预防医学,2015,27(12):1189-1193.]
[8]Sun GF,Zhao E,Xie HF,et al.Analysis of screening effect of early diagnosis and treatment of urban cancer in Urumqi in 2014[J].China Primary Health Care,2018,32(3):57-60.[孙高峰,赵娥,谢惠芳,等.乌鲁木齐市2014年城市癌症早诊早治筛查效果分析[J].中国初级卫生保健,2018,32(3):57-60.]
[9]Liu YZ,Kong YX,Luo XH,et al.Screening analysis of early diagnosis and treatment of urban cancer in Xuzhou City from 2014 to 2016[J].Jiangsu Preventive Medicine,2018,29(4):382-388.[刘亚洲,孔蕴馨,罗小虎,等.2014-2016年徐州市城市癌症早诊早治筛查分析[J].江苏预防医学,2018,29(4):382-388.]
[10]Zhang Q,Huang YC,Shen LD,et al.Cancer risk assessment and screening results of 127 960 urban residents in Yunnan Province[J].China Cancer,2018,27(9):641-646[张强,黄云超,沈丽达,等.云南省127960名城市居民癌症风险评估及筛查结果分析[J].中国肿瘤,2018,27(9):641-646.]
[11]Du J,He M,Qiu H,et al.Analysis of lung cancer screening results among urban residents in Chongqing from 2012to 2017[J].China Cancer,2018,27(5):328-332.[杜佳,何美,邱惠,等.2012~2017年重庆城市居民肺癌筛查结果分析[J].中国肿瘤,2018,27(5):328-332.]
[12]Zhao SD,He L.Cancer screening analysis of urban residents in Jincheng City in 2015[J].China Health Industry,2016,5:71-73.[赵山斗,贺鹭.2015年晋城市城市居民癌症筛查分析[J].中国卫生产业,2016,5:71-73.]
[13]Zhang N,Zhang X,Zhou QJ.Survey of lung cancer risk factors among residents over 65 years old in Shanghai community[J].China General Practice,2018,21(36):4489-4492.[张宁,张贤,周谦君.上海社区65岁以上居民肺癌危险因素现况调查[J].中国全科医学,2018,21(36):4489-4492.]
[14]Li H,Gong QH,Sun XH,et al.Risk assessment and clinical screening of malignant tumors among urban residents in Ningbo[J].Preventive Medicine,2017,29(10):1024-1026.[李辉,龚清海,孙校华,等.宁波市城市居民恶性肿瘤风险评估及临床筛查结果分析[J].预防医学,2017,29(10):1024-1026.]