上海市社区肝癌高危人群早发现干预效果的研究

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目的:研究肝癌高危人群定期筛检早发现在社区推广实施的效果。方法:在上海市的卢湾和松江2个区中19个社区开展了基于健康档案的肝癌高危人群筛选工作,通过健康教育的干预,邀请这些高危对象参加每半年AFP加B超的检查,并跟踪随访其参加情况和发生肝癌的情况。结果:44个月的观察期内,在3280例的筛检队列中,筛检检出率是114.56/10万人年,早中期检出率是65.46/10万人年。队列中规范参加筛检的比例为36.95%,其肝癌年发病率是普通人群肝癌发病的6.3倍,死亡率是普通人群肝癌死亡率的1.1倍,肝癌的早中期比例高于普通人群。具有不同的危险因素者肝癌检出率有明显差异,其中慢性肝炎史合并肝硬化的高危人群的检出率最高。结论:规范参加筛检的高危人群中发现肝癌的早中期比例高于普通人群,其差异可能是参加筛检的效果;本研究观察到的肝癌高危人群的特点将为今后设计和实施以社区为基础的肝癌高危人群筛检工作提供有益的借鉴。 Objective: To study the effect of regular screening in high-risk groups of liver cancer detected early in community promotion and implementation. Methods: The screening of high risk population of HCC patients based on health records was carried out in 19 communities in two districts of Luwan and Songjiang in Shanghai. Through the intervention of health education, these high-risk patients were invited to participate in the AFP plus B-ultrasound examination every half year and follow up Follow-up of their participation and the occurrence of liver cancer. Results: During the 44-month observation period, the screen detection rate was 114.56 / 100000 person-years in the 3280 screening cohorts, and 65.46 / 100000 person-years in the early and middle stages. The percentage of normative screening in the cohort was 36.95%. The annual incidence of liver cancer was 6.3 times that of the general population. The mortality rate was 1.1 times that of the general population. The proportion of liver cancer in the early and middle stages was higher than that of the general population. There are significant differences in the detection rate of liver cancer with different risk factors, of which the detection rate of chronic hepatitis with high risk of cirrhosis is the highest. CONCLUSIONS: The proportion of early to mid-stage hepatocellular carcinoma found in the high-risk groups that screened for screening is higher than that in the general population. The difference may be the effect of screening. The characteristics of high-risk groups of hepatocellular carcinoma observed in this study will be designed and implemented in the future. Based screening of high-risk populations of liver cancer provide a useful reference.
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