1、中國(guó)結(jié)直腸癌篩查實(shí)踐方案,Zhang Suzhan Cancer institute, Zhejiang university,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

2、-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,中

3、國(guó)部分地區(qū)1991-2000 癌癥死亡率(1/100 000),China Oncology 2002;(11)5,Distribution of CRC high incidence area in China,Red represents high incidence area,Data in 1970s,中國(guó)結(jié)直腸癌篩查項(xiàng)目,國(guó)家“十一五科技支撐計(jì)劃”(2006-2009) 國(guó)家科學(xué)技術(shù)部 癌癥早診早治項(xiàng)目(2006-2013) 國(guó)家衛(wèi)生部癌癥基金會(huì),中國(guó)結(jié)直腸癌篩查流程圖,Questionnaire survey,iFOBT,(+),(+),158926,106412,14034,85

4、31,750(8.8%),763(8.9%),57(0.7%),35(0.4%),Age 40-74, invited to screen,Complete questionnaire and FOBT,Questionnaire(+) or FOBT(+),Complete colonoscopy,腺瘤,其它息肉,早期癌,進(jìn)展期癌,初篩順應(yīng)性 67%,結(jié)腸鏡順應(yīng)性 61%,陽(yáng)性率 13.2%,1605,Colorectal Neoplasm,陽(yáng)性率 18.8%,都市: 上海，哈爾濱，杭州 鄉(xiāng)村：海寧縣，嘉善縣,QS & FOBT貢獻(xiàn),腺瘤,Ques(+) 465(61%) 457(61%)

5、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,其它息肉,癌,all,61% adenoma were discovered by Questionnaire but missed by FOBT,中國(guó)城市和鄉(xiāng)村的篩查順應(yīng)性,Screen compliance in counties is much better than that in large cities,Rural area,Urban area,

6、Data in 2008,0.00,0.10,0.20,0.30,0.40,0.50,0.60,0.70,0.80,0.90,1.00,0,1,2,3,4,5,6,7,screening,control,Accumulation mortality for colon cancer in Jiashan County,years,Zhengs,zhangsz, Dis colon rectum,2003, 46：51-58,Accumulation mortality for rectal cancer in Jiashan County 31.7%,Years,Zhengs,zhangsz,

7、 Dis colon rectum,2003, 46：51-58,Zhengs,Zhangsz, Dis colon rectum,2003, 46：51-58,現(xiàn)行方案,4074歲個(gè)體, 問(wèn)卷： (1)一級(jí)親屬大腸癌史 (2)本人有癌癥史 (3) 本人腸息肉史 (4) 具有以下二項(xiàng)及二項(xiàng)以上者: 慢性腹瀉； 粘液血便； 慢性便秘； 慢性闌 尾炎； 精神刺激史； 慢性膽道疾病史。 大便潛血 iFOBT, 1 周間隔 全結(jié)腸鏡 問(wèn)卷或陽(yáng)性推薦全結(jié)腸鏡檢查y,CRC Screeing Program in China 2010,Red represents high incidence area,Hu