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中国结直肠癌筛查实践方案

中国结直肠癌筛查实践方案. Zhang Suzhan Cancer institute, Zhejiang university. 中国部分地区 1991-2000 癌症死亡率 (1/100 000). urban area rural area organ 1991 2000 increase(%) 1991 2000 increase(%)

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中国结直肠癌筛查实践方案

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  1. 中国结直肠癌筛查实践方案 Zhang Suzhan Cancer institute, Zhejiang university

  2. 中国部分地区1991-2000 癌症死亡率(1/100 000) urban area rural area organ 1991 2000 increase(%) 1991 2000 increase(%) all 123.92 146.61 18.31 101.39 112.57 11.03 lung 32.53 42.08 29.38 14.29 21.11 47.73 liver 19.36 22.19 13.04 22.25 26.06 17.12 stomach 19.69 19.94 1.27 22.55 20.94 -7.14 colon/rectum 8.53 11.19 31.18 5.14 6.04 17.51 oesophagus 8.94 9.06 1.34 16.32 15.24 -6.62 breast 3.11 4.32 38.91 1.51 2.11 39.73 leukemia 3.60 3.82 6.11 3.31 3.18 -3.93 nasopharynx 2.17 2.14 -1.38 1.70 1.78 4.72 cervix 1.49 1.08 -27.52 2.31 1.91 -17.32 baldder 1.83 2.26 23.50 0.89 1.11 19.82 China Oncology 2002;(11)5

  3. Distribution of CRChigh incidence area in China Red represents high incidence area Data in 1970s

  4. 中国结直肠癌筛查项目 • 国家“十一五科技支撑计划”(2006-2009) 国家科学技术部 • 癌症早诊早治项目(2006-2013) 国家卫生部．癌症基金会

  5. 中国结直肠癌筛查流程图 Questionnaire survey iFOBT (+) (+)

  6. 都市: 上海，哈尔滨，杭州 乡村：海宁县，嘉善县 Age 40-74, invited to screen 158926 Complete questionnaire and FOBT 初筛顺应性 67% 106412 阳性率 13.2% Questionnaire(+) or FOBT(+) 14034 结肠镜顺应性 61% Complete colonoscopy 8531 阳性率18.8% 1605 Colorectal Neoplasm 750(8.8%) 763(8.9%) 57(0.7%) 35(0.4%) 腺瘤 　　进展期癌 其它息肉 早期癌

  7. QS & FOBT贡献 其它息肉 腺瘤 癌 all Ques(+) 465(61%) 457(61%) 19(21%) 941(59%) FOBT(+) 245(32%) 225(30%) 50(54%) 520(32%) Both(+) 53(7%) 68(9%) 23(25%) 144(9%) all 763 750 92 1605 61% adenoma were discovered by Questionnaire but missed by FOBT

  8. 中国城市和乡村的筛查顺应性 Rural area Urban area Screen compliance in counties is much better than that in large cities Data in 2008

  9. 1.00 0.90 screening 0.80 control 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0 1 2 3 4 5 6 7 years Accumulation mortality for colon cancer in Jiashan County Zhengs,zhangsz, Dis colon rectum,2003, 46：51-58

  10. Years Accumulation mortality for rectal cancer in Jiashan County31.7% Zhengs,Zhangsz, Dis colon rectum,2003, 46：51-58 Zhengs,zhangsz, Dis colon rectum,2003, 46：51-58

  11. 现行方案 40－74岁个体, 问卷： (1)一级亲属大肠癌史 (2)本人有癌症史 (3) 本人肠息肉史 (4) 具有以下二项及二项以上者: ① 慢性腹泻；② 粘液血便；③ 慢性便秘；④ 慢性阑 尾炎； ⑤ 精神刺激史；⑥ 慢性胆道疾病史。 大便潜血　　　２ iFOBT, 1 周间隔 • 全结肠镜 问卷或ＦＯＢＴ阳性推荐全结肠镜检查y

  12. CRC Screeing Program in China 2010 Beijing 1 Tianjin 1 Ninxia 1 Sanxi 1 Sandong 1 Hubei 2 Shanghai 1 Zhejiang 2 Yunnan 1 Sichuan 1 Red represents high incidence area Guangdong 1

  13. 谢谢您

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