中国结直肠癌筛查实践方案.ppt

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1、中国结直肠癌筛查实践方案urbanarearuralareaorgan19912000increase(%)19912000increase(%)all123.92146.6118.31101.39112.5711.03lung32.5342.0829.3814.2921.1147.73liver19.3622.1913.0422.2526.0617.12stomach19.6919.941.2722.5520.94-7.14colon/rectum8.5311.1931.185.146.0417.51oesophagus8.949.061.3416.3215.

2、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中国部分地区1991-2000癌症死亡率(1/100000)ChinaOncology2002;(11)5DistributionofCRChighincidenceareainChinaRedrepresentshi

3、ghincidenceareaDatain1970s中国结直肠癌筛查项目国家“十一五科技支撑计划”(2006-2009)国家科学技术部癌症早诊早治项目(2006-2013)国家卫生部．癌症基金会中国结直肠癌筛查流程图QuestionnairesurveyiFOBT(+)(+)158926106412140348531750(8.8%)763(8.9%)57(0.7%)35(0.4%)Age40-74,invitedtoscreenCompletequestionnaireandFOBTQuestionnaire(+)orFOBT(+)Completecolono

4、scopy腺瘤其它息肉早期癌进展期癌初筛顺应性67%结肠镜顺应性61%阳性率13.2%1605ColorectalNeoplasm阳性率18.8%都市:上海，哈尔滨，杭州乡村：海宁县，嘉善县QS&FOBT贡献腺瘤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%adenomawerediscoveredbyQuestionnairebutmiss

5、edbyFOBT中国城市和乡村的筛查顺应性ComplianceforfirstscreenComplianceforcolonoscopyHighriskindividualsHaining89.8%79.6%16.5%Jiashan88.9%78.0%12.6%Hz,Hb,Sh45.6%34.8%13.3%ScreencomplianceincountiesismuchbetterthanthatinlargecitiesRuralareaUrbanareaDatain20080.000.100.200.300.400.500.600.700.800.901.

6、0001234567screeningcontrolAccumulationmortalityforcoloncancerinJiashanCountyyearsZhengs,zhangsz,Discolonrectum,2003,46：51-58AccumulationmortalityforrectalcancerinJiashanCounty31.7%YearsZhengs,zhangsz,Discolonrectum,2003,46：51-58Zhengs,Zhangsz,Discolonrectum,2003,46：51-58现行方案40－74岁个体,

7、问卷：(1)一级亲属大肠癌史(2)本人有癌症史(3)本人肠息肉史(4)具有以下二项及二项以上者:①慢性腹泻；②粘液血便；③慢性便秘；④慢性阑尾炎；⑤精神刺激史；⑥慢性胆道疾病史。大便潜血２iFOBT,1周间隔全结肠镜问卷或ＦＯＢＴ阳性推荐全结肠镜检查yCRCScreeingPrograminChina2010RedrepresentshighincidenceareaHubei2Yunnan1Sichuan1Shanghai1Zhejiang2Guangdong1Beijing1Tianjin1Sanxi1Sandong1Ninxia1谢谢您