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2022—2024年黄山市上消化道癌机会性筛查结果分析
何玉琢, 郑瑞丰, 程韶光, 陈义, 汪朝辉, 邓国强
安徽预防医学杂志 ›› 2026, Vol. 32 ›› Issue (1) : 79-84.
PDF(974 KB)
PDF(974 KB)
2022—2024年黄山市上消化道癌机会性筛查结果分析
Opportunistic screening results for upper gastrointestinal cancers in Huangshan from 2022 to 2024
目的 分析2022—2024年黄山市上消化道癌机会性筛查结果，为优化筛查策略提供依据。方法 基于国家项目平台数据，纳入黄山市6家医院就诊患者，根据意愿进行无痛或普通内镜检查，按国家方案进行染色和活检。采用SAS 9.4软件进行统计分析，计算病理活检率、阳性病变检出率和早诊率，并按性别、年龄、染色情况、内镜类型和筛查对象来源分组比较。结果 共纳入65 373人，上消化道总病理活检率为36.79%（食管2.95%、贲门1.51%、胃33.10%）；检出阳性病变1 779例，检出率为2.72%，其中早期病变340例，早诊率为19.11%。阳性病变检出率随年龄增长上升（χ2趋势=40.567，P<0.001），男性高于女性（χ2=398.289，P<0.001），住院人群高于门诊和体检人群（χ2=1 085.719，P<0.001）。化学染色和电子+化学染色组的检出率和早诊率均高于未染色和单纯电子染色组（χ2=294.726，P<0.001；χ2=137.169，P<0.001）；无痛内镜组早诊率高于普通内镜组（χ2=5.363，P=0.021）。结论 黄山市上消化道癌机会性筛查检出率尚可，但早诊率偏低。应加强规范化培训和质控，推广无痛胃镜和化学染色技术，并针对男性、高龄等高危人群开展靶向健康教育，以提升早诊率和筛查效果。
Objective To analyze the results of opportunistic screening for upper gastrointestinal cancer in Huangshan from 2022 to 2024, and to provide evidence for optimizing screening strategies. Methods Based on data from the national project platform, patients from six hospitals in Huangshan were included. Patients underwent painless or conventional endoscopy based on preference, with staining and biopsy performed according to the national protocol. Statistical analysis was conducted using SAS 9.4 software, pathological biopsy rate, positive lesion detection rate, and early diagnosis rate were calculated and compared by sex, age, staining status, endoscopy type, and source of screening subjects. Results A total of 65 373 individuals were included. The overall pathological biopsy rate for upper gastrointestinal lesions was 36.79% (esophagus: 2.95%, cardia: 1.51%, stomach: 33.10%). Positive lesions were detected in 1 779 cases, with a detection rate of 2.72%. Among these, 340 cases were early-stage lesions, with an early diagnosis rate of 19.11%. The detection rate of positive lesions increased with age (χ2trend =40.567, P<0.001), and was higher in males than in females (χ2=398.289, P<0.001). The detection rate of positive lesions was higher in hospitalized patients than in outpatients and physical examination populations (χ2=1 085.719, P<0.001). The detection rate and early diagnosis rate of chemical staining group and electronic+chemical staining group were significantly higher than those in no staining group and electronic staining alone group (χ2=294.726, P<0.001; χ2=137.169, P<0.001). The early diagnosis rate of painless endoscopy group was higher than that of the conventional endoscopy group (χ2=5.363, P=0.021). Conclusion The detection rate for opportunistic screening of upper gastrointestinal cancer in Huangshan is acceptable, but the early diagnosis rate remains relatively low. Standardized training and quality control should be enhanced, along with promoting painless gastroscopy and chemical staining techniques. Targeted health education for high-risk groups, such as males and older adults, is essential to improve early diagnosis and screening effectiveness.
上消化道癌 / 机会性筛查 / 阳性病变 / 检出率 / 早诊率
Upper gastrointestinal cancer / Opportunistic screening / Positive lesions / Detection rate / Early diagnosis rate
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This article has been corrected. The original version (PDF) is appended to this article as a Supplement.Although consumption of tea at high temperatures has been suggested as a risk factor for esophageal cancer, an association has not been observed consistently, and whether any relationship is independent of alcohol and tobacco exposure has not been evaluated.To examine whether high-temperature tea drinking, along with the established risk factors of alcohol consumption and smoking, is associated with esophageal cancer risk.China Kadoorie Biobank, a prospective cohort study established during 2004 to 2008.10 areas across China.456 155 persons aged 30 to 79 years. Those who had cancer at baseline or who reduced consumption of tea, alcohol, or tobacco before baseline were excluded.The usual temperature at which tea was consumed, other tea consumption metrics, and lifestyle behaviors were self-reported once, at baseline. Outcome was esophageal cancer incidence up to 2015.During a median follow-up of 9.2 years, 1731 incident esophageal cancer cases were documented. High-temperature tea drinking combined with either alcohol consumption or smoking was associated with a greater risk for esophageal cancer than hot tea drinking alone. Compared with participants who drank tea less than weekly and consumed fewer than 15 g of alcohol daily, those who drank burning-hot tea and 15 g or more of alcohol daily had the greatest risk for esophageal cancer (hazard ratio [HR], 5.00 [95% CI, 3.64 to 6.88]). Likewise, the HR for current smokers who drank burning-hot tea daily was 2.03 (CI, 1.55 to 2.67).Tea consumption was self-reported once, at baseline, leading to potential nondifferential misclassification and attenuation of the association.Drinking tea at high temperatures is associated with an increased risk for esophageal cancer when combined with excessive alcohol or tobacco use.National Natural Science Foundation of China and National Key Research and Development Program.
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Although socioeconomic status (SES) has been associated with cancer risk, little research on this association has been done in Japan. To evaluate the association between SES and digestive tract cancer risk, we conducted a case-control study for head and neck, esophageal, stomach, and colorectal cancers in 3188 cases and the same number of age- and sex-matched controls within the framework of the Hospital-based Epidemiological Research Program at Aichi Cancer Center III (HERPACC III). We employed the education level and areal deprivation index (ADI) as SES indicators. The association was evaluated with odds ratios (ORs) and 95% confidence intervals (CIs) by conditional logistic models adjusted for potential confounders. Even after allowance for known cancer risk factors, the education level showed linear inverse associations with head and neck, stomach, and colorectal cancers. Compared to those educated to junior high school, those with higher education showed statistically significantly lower risks of cancer (0.43 (95% CI: 0.27–0.68) for head and neck, 0.52 (0.38–0.69) for stomach, and 0.52 (0.38–0.71) for colorectum). Consistent with these results for the educational level, the ADI in quintiles showed positive associations with head and neck, esophageal, and stomach cancers (p-trend: p = 0.035 for head and neck, p = 0.02 for esophagus, and p = 0.013 for stomach). Interestingly, the positive association between ADI and stomach cancer risk disappeared in the additional adjustment for Helicobacter pylori infection and/or atrophic gastritis status. In conclusion, a lower SES was associated with an increased risk of digestive cancers in Japan and should be considered in cancer prevention policies for the target population.
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利益冲突声明 全部作者声明无利益冲突
志谢感谢黄山市人民医院、黄山区人民医院、歙县人民医院、休宁县人民医院、黟县人民医院、祁门县人民医院及区县疾控中心在上消化道癌机会性筛查及早诊早治项目工作中的辛勤付出
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