摘要目的 回顾调查经医院健康体检检出的病例的特点,探讨医院健康体检对于癌症筛查和早期发现的效果,着重评价其中大肠癌和乳腺癌的效果.方法 2011-2012年上海交通大学医学院附属仁济东院体检中心共完成体检170 646人次,回顾其中4 179名阳性随访病例,在Access 2007中通过其基本信息与上海市疾病预防控制中心的肿瘤登记系统进行链接,获得确诊肿瘤病例情况,用Excel 2007分析肿瘤检出率、检出顺位、年龄分布、性别分布和早期比例等指标,年龄分布以10岁为一个年龄组分段计算检出率.结果 检出肿瘤81例,检出率47.47/10万;60～69岁年龄段检出率(105.36/10万)最高;男女性别比为1.25∶1;检出病例中确诊大肠癌1例,检出率0.79/10万(1/126 066);乳腺癌11例,检出率17.22/10万(11/63 866),临床分期Ⅰ期比例71％(5/7),高于2005-2009年上海市乳腺癌病例Ⅰ期比例(33％).结论 建议在体检项目中增加便隐血检测,提高便隐血检测的参与率,以提高体检人群对大肠癌筛查手段的知晓率和大肠癌的检出率;健康体检筛出乳腺癌的早期比例高于自然人群,表明医院健康体检对乳腺癌的早期发现是有效的.

abstractsObjective To explore the effect of health check-up on screening and early detection of colorectal or breast cancer.Methods A total of 4 179 health check-up receivers were enrolled in this investigation.Basic health information was linked to the Shanghai Cancer Registry System and confirmed cancer diagnosis through Access 2007.Excel 2013 was used to analyze cancer detection rate,ranking,age and sex distribution and early stage proportion.Results During 2011 and 2012,81 cancer cases were identified,with a detection rate of 47.47/100 000.The highest detection rate was found in 60-69 years old group (105.36/100 000),and male:female ratio was 1.25 ∶ 1.One colorectal cancer was diagnosed,resulting in a detection rate of 0.79/100 000.Eleven breast cancers were diagnosed,with a detection rate of 17.22/100 000.Early stage breast cancer accounted for 71％,which was higher than average level between 2005-2009 (33％).Conclusion Detection rate of colorectal cancer among health check-up receivers was very low,which is inconsistent with the high incidence of colorectal cancer in Shanghai.Fecal occult-blood test should be performed during health check-up,which may increase colorectal cancer detection.Moreover,health check-up may contribute to early detection of breast cancer.