摘要
[目的]研究上海市静安区大肠癌高危人群肠镜筛查顺应性的影响因素,为该地区大肠癌早筛防治策略提供参考依据。[方法]应用简单随机抽样方法抽取2013年静安区大肠癌筛查的高危人群2 061人进行问卷调查,分析其肠镜筛查顺应性及其影响因素。[结果]有效问卷1 817份,有效率88.16%。578人接受了肠镜筛查,肠镜筛查顺应性为31.81%。多因素logistic回归分析显示,"没症状,觉得意义不大"(OR=10.95)、"定期体检,未查出问题"(OR=1.93)、"没有时间去做"(OR=2.63)、"已经出现大肠癌症状"(OR=2.23)、"初筛阳性结果危险度分类"(OR=2.04/3.95)是提高肠镜筛查顺应性的不利因素,"50岁以上人群,即便无肛肠症状,也应每年一次肛指检查和隐血试验,每5年一次肠镜检查"(OR=0.46)、"肠镜检查前肠道准备复杂"(OR=0.15)、"医院检查有绿色通道"(OR=0.55)、"社区医师建议做肠镜筛查"(OR=0.52)、"二、三级医院医师建议肠镜筛查"(OR=0.50)、"如果肠镜筛查免费,愿意参加"(OR=0.54)是提升肠镜筛查顺应性的有利因素。[结论]社会人口学因素与肠镜筛查顺应性无关联,而提升大肠癌高危人群肠镜筛查顺应性的手段主要有:政府加大肠镜筛查知识宣教力度,增加费用减免力度,扩大绿色通道范围,加强医生培训,规范体检项目,针对不同危险度分类高危人群,采取不同筛查策略。
[ Objective ] To investigate the influencing factors of compliance to colonoscopy among colorectal cancer （CRC） high-risk populations in Jing＇an District of Shanghai, and to provide evidence for early-stage colorectal screening and prevention in this area. [ Methods ] In 2013, 2061 volunteers at high risk of CRC in Jing＇an District were selected by simple random sampling and interviewed using structured questionnaire to analyze their compliance to colonoscopy and related influencing factors. [ Results ] There were totally 1817 valid questionnaires with a valid rate of 88.16%, and 578 volunteers received colonoscopy with a compliance rate of 31.81%. According to logistic regression analysis, ＂no symptoms and regarding eolonoscopy as meaningless＂ （OR=10.95）, ＂no disease diagnosed in routine health checks＂ （OR=1.93）, ＂no time＂ （OR=2.63）, ＂symptoms occurred already＂ （OR=2.23）, and ＂classification of positive results＂ （OR=2.04/3.95） were unfavorable factors; by contrast, ＂awareness of types and frequencies of colon examinations＂ （OR=0.46）, ＂complex colorectal preparation before colonoscopy＂ （OR=0.15）, ＂easy access in hospitals＂ （OR=0.55）, ＂advices from community physicians＂ （OR=0.52）, ＂advices from physicians of secondary and tertiary hospitals＂ （OR=0.50）, ＂being willing of taking screening if free of charge＂ （OR=0.54） were favorable factors. [ Conclusion ] No correlation has been found between social-demographic factors and colonoscopy compliance. There are several methods to improve colonoscopy compliance among the high-risk population of colorectal cancer. The government should strengthen health promotion on colonoscopy knowledge, increase the proportion of fee exemption, extend easy access in hospitals, enhance training on physicians, provide more standardized physical check-ups, classify high-risk populations according to different risk level, and conduct varied screening strategies.
出处
《环境与职业医学》
CAS
CSCD
北大核心
2016年第5期421-426,共6页
Journal of Environmental and Occupational Medicine
基金
上海市青年医师培养资助计划(编号:沪卫人事[2012]114号)
关键词
大肠癌
高危人群
肠镜筛查
顺应性
影响因素
colorectal cancer
high-risk population
colonoscopy
compliance＇, influencing factor
