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[目的]通过社区肿瘤早发现模式的实践,为肿瘤防治的健康促进提供可借鉴的经验。[方法]通过癌情资料分析,小组座谈,对闵行区40岁以上健康卡签约人口通过社区教育、因症就诊、体检进行大肠癌、肝癌、胃癌及肺癌四癌早发现危险度问卷,建立初筛及高危队列,后续长效管理。并进行效果评估。[结果]人群“四癌”早发现知识知晓性由55.21%提高到70.00%(P<0.05),态度转变率由71.44%提高到83.11%(P<0.05);470805人次完成健康教育,覆盖40岁以上人口40.47%;规范初筛282487人,规范初筛率96.25%,初筛阳性4350人,阳性复查率47.72%,检出高危人群11241人,纳入高危人群管理10286人,确诊296例,Ⅰ期77例,占26.01%,Ⅱ期49例,Ⅰ+Ⅱ期率42.57%;初筛依从性均较好;胃镜、AFP与CT复查依从性一般,四癌筛查效果均具一定成效,大肠癌效果最为显著。[结论]以健康教育先导,结合定期的筛查评估,高危人群长效管理的综合干预,使社区居民对肿瘤早发现的知、信、行有了明显的变化,根据肿瘤早发现和癌前期病变的检出结果,说明基于社区系统的干预和管理对常见肿瘤早发现的提高和远期发病率的减低起到举足轻重的作用,是社区肿瘤早发现的有效手段。
[Objective] Through the practice of community cancer early detection mode, it can provide reference experience for the promotion of cancer prevention and treatment. [Methods] Through cancer information analysis and group discussion, the questionnaire about the early detection of the risk of four cancer of colorectal cancer, liver cancer, stomach cancer and lung cancer by community education, medical examination and physical examination was established for the population over 40 years of health card in Minhang District. Screening and high-risk queue, the follow-up long-term management. And evaluate the effect. [Results] Early awareness of awareness was found to be increased from 55.21% to 70.00% (P <0.05), and the rate of attitude change from 71.44% to 83.11% (P <0.05). 470805 people completed health education, Covering 40.47% of the population over the age of 40; standardized initial screening of 282487 people, standardized screening rate of 96.25%, 4350 positive screening, positive review rate was 47.72%, 11241 people were detected at high risk, 10286 were included in the management of high-risk population, 296 cases , Stage Ⅰ 77 cases, accounting for 26.01%, stage Ⅱ 49 cases, stage Ⅰ + Ⅱ 42.57%; the primary screening compliance are better; gastroscopy, AFP and CT review compliance in general, the screening results of all four cancers have a certain effect Colorectal cancer is the most significant. [Conclusion] With the comprehensive intervention of health education pilot, combined with regular screening assessment and long-term management of high-risk groups, community residents have obvious changes in knowledge, letter and practice of early detection of tumor. According to early detection and precancerous The results of pathological examination showed that intervention and management based on community-based system played an important role in the early detection of common tumors and the reduction of long-term morbidity, which is an effective means of early detection of community tumors.