摘要目的 探讨家用型粪隐血自测方法在社区用于大肠癌筛查的可行性,从而提高社区大肠癌筛查的依从性.方法 2013年8月至2014年1月对北京市东城区社区卫生服务站的6 147名社区医生及居民采用面对面问卷调查的方式进行大肠癌社区筛查意愿方式问卷调查,共收回调查问卷6 147份,其中有效问卷5 943份(社区医生114份,社区居民5 829份).问卷调查表结果采用x2检验、logistic回归分析进行统计学分析.结果 参与调查的社区医生有88.6％(101/104)、社区居民中有69.1％(4 026/5 829)表示愿意选择家用型粪隐血自测方法进行筛查.社区医生中,不同性别(x2=0.064)、年龄(x2=0.287)、是否有大肠癌高危因素(x2=0.969)、家用型粪隐血自测方法认知度(x2=0.393)之间对家用型粪隐血自测方法用于社区筛查的意愿差异无统计学意义(P均＞0.05).社区居民中,不同性别(x2=6.385,P=0.012)、年龄(x2=25.644,P=0.000)、是否为大肠肿瘤高危人群(x2=524.774,P=0.000)、家用型粪隐血自测方法的认知度(x2=25.644,P=0.000)之间对家用型粪隐血自测方法用于社区筛查的意愿差异有统计学意义.是否有大肠癌高危因素对家用型粪隐血自测方法用于社区结直肠癌筛查意愿的影响最大OR(95％CI)值为8.594(7.279～10.148).有大肠癌高危因素的调查者相比无高危因素、男性相比女性、曾经使用过或知晓家用型粪隐血自测方法者更愿意接受其用于社区大肠癌筛查.结论 家用型粪隐血自测方法简便、快捷,用于结直肠癌社区筛查易于被居民接受,可实现其粪隐血检测的自我管理,从而提高结直肠肿瘤筛查的依从性.

abstractsObjective To explore the feasibility of "home-based" fecal occult blood self-test (home FOBTself-test) in the community colorectal cancer (CRC) screening,thereby to improve the community's compliance with colorectal cancer screening.Method Community medical staff and residents in Dongcheng District was recruited by means of self-reported questionnaires about personal wishes for home FOBT self-test screening since August 2013 to January 2014.Finally,using x2 test and logistic regression analysis to analyze the results of the final questionnaire.Of the total of 6,147 copies of the questionnaire,5 943 copies were valid questionnaires (Community medical staff:resident=114:5 829).Results 88.6％ of community medical staff and 69.1％ of community residents expressed willingness to choose home self-test FOBT.Univariate analysis showed that wishes of community medical staff for FOBT screening were unrelated with gender (P=0.635),age (P=1.000),CRC high-risk or not (P=0.418),awareness of home self-test FOBT(P=0.693).The wishes of community residents for FOBT screening related with gender (P=0.012),age (P=0.000),CRC high-risk or not (P=0.000),awareness of home self-test FOBT (P=0.000).Colorectal cancer risk was the greatest impact on wishes for FOBT screening (OR 值 (95％ CI) =8.594 (7.279-10.148)).Conclusions Home FOBT self-test was simple,fast,easy to use and widely accepted in CRC screening of community residents,therefore it may improve the community's compliance with colorectal cancer screening.Screening for CRC is strongly recommended.