关键词: 糖尿病, 肠肿瘤, 社区卫生中心, 筛查

Abstract: Background　With the changes in modern lifestyles，the incidence of diabetes and colorectal cancer is increasing gradually.The study of the relationship between diabetes and colorectal cancer proves that diabetes is a high risk factor for colorectal cancer，and regular screening for colorectal cancer should be noted.Objective　To analyze the results of patients with diabetes mellitus participating in colorectal cancer screening，and provide more technical references for the management of chronic diseases in community diabetes in the future.Methods　319 diabetic patients who participated in colorectal cancer screening in communities under the jurisdiction of Shanghai Baiyu community health service center from 2016 to 2018 were selected.Two questionnaires were issued at the beginning of the study.One was a health checklist designed by the center based on the requirements of the medical examination.The main purpose was to investigate whether the residents who participated in the screening had a history of diabetes mellitus.Another Shanghai Community Residents Colorectal Cancer Screening Risk Assessment Form prepared for screening for colorectal cancer in Shanghai included basic information（gender，age，marital status，education level，occupation） and risk factors of colorectal cancer（chronic diarrhea，history of chronic constipation，history of mucus and bloody stool，history of chronic appendicitis or appendectomy，history of chronic cholecystitis or cholecystectomy，history of intestinal polyps，history of schistosomiasis，history of cancer，history of first-degree relatives with cancer，history of trauma） and primary screening results（positive occult blood test，positive risk assessment，and any positive results for primary screening）.In the later stage of the study，the questionnaires prepared by the center were distributed，its content included whether to have colonoscopy，colonoscopy results，and recognition related to colonoscopy （fear of colonoscopy，thinking that there will be no problem and worrying about the uncomfortable consequences after the examination，the psychological burden of finding out the problem，the lack of time and interest，and the benefit of colonoscopy）.Results　A total of 319 patients with diabetes were enrolled.The age ranged from 60 to 69 years old（45.8%）.The marital status was mainly married （91.2%）.The education level was mainly secondary specialized school/ secondary school （57.1%）.State-owned enterprise was the mainstay occupation（39.8%）.The risk factors of colorectal cancer were chronic appendicitis or history of appendectomy，history of intestinal polyps，and chronic cholecystitis or history of cholecystectomy，which were 14.7%，13.8%，and 13.5%，respectively.The positive rate of occult blood was 6.6%（21/319），the positive rate of risk assessment was 18.2%（58/319），and the double positive rate was 6.0%（19/319）.There were 79 patients with positive screening and 23 patients underwent colonoscopy.Among them，patients with no lesion accounted for 39.1%，enteritis accounted for 26.1%，and polyps accounted for 21.7%.Of 79 patients who had positive screening results，39 were considered they could benefit from colonoscopy and 22 were afraid of colonoscopy.Conclusion　About 25% of the community diabetes patients with colorectal cancer screening positive， especially pay attention to patients with history of chronic appendicitis or appendectomy， chronic cholecystitis or cholecystectomy， and intestinal polyp..

Key words: Diabetes mellitus, Intestinal neoplasms, Community health centers, Screening