目的 分析马鞍山市社区肺癌高危人群参与低剂量螺旋CT (low-dose computed tomography,LDCT)免费筛查的依从性及相关影响因素,探讨提高筛查水平的方法。方法 通过肺癌风险评估问卷共收集10 038名社区居民的基线资料,包括行为习惯、人口学特征、个人疾病史和家族史等内容,参照《中国肺癌低剂量螺旋CT筛查指南》共筛选出高危人群3 376人作为研究对象,使用χ2检验和logistic回归分析影响免费LDCT筛查依从性的因素。结果 高危人群中共有2 289人参与LDCT检查,参与率为67.80％,男性1 581人,占69.07％,女性708人,占30.93％。多因素 logistic回归显示,女性 (OR=1.373,95％CI:1.029~1.833)、 年龄60~69岁(OR=1.724,95％CI:1.436~2.071)、≥70岁(OR=1.489,95％CI:1.190~1.864)、每周锻炼5次及以上 (OR=1.337,95％CI:1.138~1.572)、有肺结核家族史(OR=1.598,95％CI:1.013~2.521)、有哮喘家族史(OR=1.695,95％CI:1.315~2.532)、有糖尿病史(OR=1.297,95％CI:1.052~1.599)、有肿瘤家族史(OR=1.692,95％CI:1.443~1.983)筛查的依从性更高;大专及以上人群(OR=0.519,95％CI:0.377~0.714)依从性更低。结论 马鞍山市肺癌高危人群LDCT筛查的依从性不高,根据影响筛查依从性的因素,针对不同的人群采取相应措施提高筛查依从性。
Abstract
Objective To analyze the compliance and related influencing factors of low-dose computed tomography (LDCT) free screening among high-risk lung cancer population in Ma’anshan City,and to explore the methods to improve the screening level. Methods A total of 10 038 community residents’ baseline data were collected through the lung cancer risk assessment questionnaire,including behavioral habits,demographic characteristics,personal disease history and family history,and so on.A total of 3 376 high-risk people were selected as the subjects of this study according to China National Lung Cancer Screening Guideline with Low-dose Computed Tomography.Factors influencing compliance of free LDCT screening were analyzed using χ2 test and logistic regression. Results A total of 2 289 people in high-risk groups participated in LDCT examination,with a participation rate of 67.80％,including 1 581 males (69.07％) and 708 females (30.93％).Multivariate logistic regression showed that females (OR=1.373,95％CI:1.029-1.833),60-69 years old (OR=1.724,95％CI:1.436-2.071),≥70 years old (OR=1.489,95％CI:1.190-1.864),exercising 5 times or more per week (OR= 1.337,95％CI:1.138-1.572),family history of tuberculosis (OR=1.598,95％CI:1.013-2.521),family history of asthma (OR=1.695,95％CI:1.315-2.532),history of diabetes (OR=1.297,95％CI:1.052-1.599),and family history of tumor (OR=1.692,95％CI:1.443-1.983) had higher screening compliance.Adherence was lower among those with college and above (OR=0.519,95％CI:0.377-0.714). Conclusion The compliance of LDCT screening for lung cancer high-risk population in Ma 'anshan City is not high.According to the influencing factors,appropriate measures should be taken to improve screening compliance for different populations.
关键词
肺癌筛查 /
低剂量螺旋CT /
依从性 /
logistic回归分析
Key words
Lung cancer screening /
Low-dose computed tomography /
Compliance /
Logistic regression analysis
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参考文献
[1] Sung H,Ferlay J,Siegel RL,et al.Global Cancer Statistics 2020:GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J].CA Cancer J Clin,2021,71(3):209-249.
[2] Zheng R,Zhang S,Zeng H,et al.Cancer incidence and mortality in China,2016[J].J Natl Cancer Cent,2022,2(1):1-9.
[3] Schütte S,Dietrich D,Montet X,et al.Participation in lung cancer screening programs:are there gender and social differences? A systematic review[J].Public Health Rev,2018,15(39):23.
[4] Zeng H,Chen W,Zheng R,et al.Changing cancer survival in China during 2003-15:a pooled analysis of 17 population-based cancer registries[J].Lancet Glob Health,2018,6(5):e555-e567.
[5] He YT,Zhang YC,Shi GF,et al.Risk factors for pulmonary nodules in north China:A prospective cohort study[J].Lung Cancer,2018,120:122-129.
[6] 郭兰伟,张韶凯,刘曙正,等.河南省城市地区低剂量螺旋CT肺癌筛查依从性及其影响因素分析[J].中华流行病学杂志,2020,41(7):1076-1080.
[7] 温艳,于连政,杜灵彬,等.中国3省城市癌症早诊早治项目地区肺癌高危人群的低剂量螺旋CT筛查依从性及相关因素分析[J].中华预防医学杂志,2021,55(5):633-639.
[8] 周清华,范亚光,王颖,等.中国肺癌低剂量螺旋CT筛查指南(2018年版)[J].中国肺癌杂志,2018,21(2):67-75.
[9] 低剂量螺旋CT肺癌筛查专家共识[J].中华放射学杂志,2015,49(5):328-335.
[10] 何耀.我国超重/肥胖流行趋势及其对公共卫生的挑战[J].中华流行病学杂志,2014,35(4):345-348.
[11] 健康体检基本项目专家共识[J].中华健康管理学杂志,2014,8(2):81-90.
[12] 严晓玲,毛阿燕,胡广宇,等.北京城市居民癌症筛查接受度分析[J].中国公共卫生,2015,31(8):1012-1015.
[13] 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.
[14] 朱俊宇,范艺馨,顾晓芬,等.乌鲁木齐市社区肺癌高危人群低剂量螺旋CT筛查结果分析[J].中国肿瘤,2016,25(6):430-432.
[15] 于志福,王晓煜,何嵘,等.2012—2017年辽宁地区城市居民肺癌筛查结果分析[J].现代预防医学,2020,47(13):2442-2445+2470.
[16] 董佩,邱五七,石菊芳,等.我国城市居民癌症筛查服务利用现况及服务支付意愿分析[J].中华流行病学杂志,2018,39(2):165-172.
[17] McRonald FE,Yadegarfar G,Baldwin DR,et al.The UK Lung Screen (UKLS):demographic profile of first 88,897 approaches provides recommendations for population screening.[J].Cancer Prev Res (Phila),2014,7(3):362-371.
[18] 潘辉,黄颖烽.我国结直肠癌筛查依从性影响因素的探讨[J].中国肿瘤,2018,27(8):578-583.
[19] 赵娥,孙高峰,谢惠芳.2016—2017年乌鲁木齐市肺癌流行病学特征分析[J].中国初级卫生保健,2019,33(6):51-53.
[20] 肖海帆,颜仕鹏,李佶刚,等.湖南省2017—2018年肺癌低剂量螺旋CT筛查结果和依从性分析[J].实用肿瘤学杂志,2022,36(2):99-104.
[21] 裴艳丽,许建名,徐冰凌,等.肺癌危险因素及早期筛查方法研究进展[J].癌症进展,2020,18(10):973-976+983.
[22] Zhang X,Jiang N,Wang L,et al.Chronic obstructive pulmonary disease and risk of lung cancer:a meta-analysis of prospective cohort studies[J].Oncotarget,2017,8(44):78044-78056.
[23] Wang GX,Baggett TP,Pandharipande PV,et al.Barriers to Lung Cancer Screening Engagement from the Patient and Provider Perspective[J].Radiology,2019,290(2):278-287.
基金
安徽省中央引导地方科技发展专项(202007d07050008);安徽省卫健委重点项目(AHWJ2021a026)
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