摘要由于物质生活水平提高和饮食结构改变,我国结直肠癌的发病率逐渐上升.癌前病变(如腺瘤)发展为肠癌常常需要较长时间,在筛查过程中发现癌前病变并予以切除(摘除),可以防止其癌变并使患者获得长期生存.开展结直肠癌筛查工作对于结直肠癌的早诊早治,提高结直肠癌生存非常有必要.中山大学肿瘤医院在广州市推动开展结直肠癌社区筛查,对目标人群采用问卷调查和粪便潜血试验,筛选出结直肠癌高危人群,通过结肠镜检查并对可疑病变进行病理活检,从而发现癌前病变及早期癌患者.2015年1—12月广州市越秀区共1031例高危人群在中山大学肿瘤防治中心接受结肠镜精筛,共发现息肉、炎性反应或肿瘤361例(35.0%),结直肠癌13例(检出率1.3%),息肉327例(检出率31.7%),腺瘤239例(检出率23.2%),进展期腺瘤140例(检出率13.6%).结直肠癌在不同性别及年龄中的检出率差异无统计学意义(P >0.05).男性的腺瘤及进展期腺瘤检出率均显著高于女性(P < 0.01).腺瘤及进展期腺瘤的检出率随年龄增长也显著提高(P<0.01).我们应推广系统性人群筛查,提高群众对癌症筛查意义的认识,真正达到癌症早诊早治.

abstractsThe incidence of colorectal cancer(CRC) in China is gradually increasing as a result of the economic development and dietary change. Since it usually takes a long time for precancerous lesions(e.g. adenoma)to develop into cancer, proper cancer screening is useful to discover and to remove these early lesions, while the patients can achieve long-term survival. Hence, developing a well-organized cancer screening system is necessary for the early detection and intervention of potential CRC. Sun Yat-sen University Cancer Center (SYSUCC)has been developing a community-based cancer screening program, using questionnaires and fecal occult blood test to identify the residents with high risks of CRC. These people will be further subjected to colonoscopy and biopsy for the suspected lesions. Among the 1 030 participants in Guangzhou Yuexiu District who received colonoscopy at SYSUCC from January to November in 2015, polyps, inflammation or tumors were found in 361(35.0%) patients, in whom 13 were colorectal cancers (1.3%), 327 were polyps(31.7%), 239 were adenoma(23.2%), and 140 were prophase adenoma(13.6%). Besides, no significant difference of CRC detection rate between male and female was found (P > 0.05), while the detection rate of polyps and prophase adenoma was higher in male than that in female, which also increased significantly with age (P < 0.01). We envision such systematic cancer screening extremely useful to enhance the understanding of cancer screening in the public and eventually to realize the early detection and treatment of cancer.