• 论著 •

### 上海市社区居民大肠癌筛查便隐血检测效果分析

1. 上海市疾病预防控制中心慢性非传染病与伤害防治所肿瘤防治科，上海 200336
• 出版日期:2018-06-30 发布日期:2018-07-20
• 通信作者: 施 燕 E-mail：shiyan@scdc.sh.cn
• 基金资助:
国家重点研发计划（2017YFC1308800，2016YFC1303200）；上海市第四轮公共卫生3年行动计划慢病重点学科建设项目（15GWZK0901，15GWZK0801）。

### The analysis of immunochemical fecal occult blood test results in colorectal cancer screening in Shanghai

PENG Peng, GONG Yangming, BAO Pingping, WU Chunxiao, GU Kai, ZHANG Minlu, XIANG Yongmei, SHI Liang, ZOU Zhen, SHI Yan

1. Division of Chronic and Non-communicable Diseases, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
• Published:2018-06-30 Online:2018-07-20
• Contact: SHI Yan E-mail: shiyan@scdc.sh.cn

Abstract: Background and purpose: Shanghai provides free colorectal cancer screening services to eligible residents. This study aimed to analyze immunochemical fecal occult blood test results in colorectal cancer screening to assess the effectiveness of twice fecal occult blood test, and to provide the evidence for community-based screening programs. Methods: Shanghai residents aged 50-74 years were target population. Twice immunochemical fecal occult blood test and risk assessment were used for initial screening, along with colonoscopy for individuals whose initial results were positive. Results: During the screening, 809 528 participants completed immunochemical fecal occult blood test twice, and 104 953 people’s test results were positive. There were 47 421 people whose initial results were positive, and the positive rate was 5.9%. There were 36 462 people who got positive results in the second test, and the positive rate was 4.5%. Another 21 070 people got positive results in both tests, and the positive rate was 2.6%. Among the individuals with positive immunochemical fecal occult blood test, 49 339 people underwent colonoscopy, and the overall colonoscopy compliance was 47.0%. The participation rate of colonoscopy was significantly higher in participants who had double positive results than in the participants with single positive result. One thousand two hundred cases (79.5%) of colorectal cancer were diagnosed and 3 777 cases (68.1%) of precancerous lesions were detected by only one fecal occult blood test. Three hundred and ten cases (20.5%) of colorectal cancer were diagnosed and 1 767 cases (31.9%) of precancerous lesions were detected by an additional fecal occult blood test. Conclusion: Compared with the only one immunochemical fecal occult blood test, the twice tests were more effective. The compliance of colonoscopy was improved among participants with double positive results, and the detective rates of colorectal cancer and precancerous lesions were increased. To improve the screening efficiency, twice or more immunochemical fecal occult blood test should be carried out in the community-based colorectal cancer screening.