关键词: 肠肿瘤, 筛查, 顺应性, 上海市, 松江区

Abstract: Objective　To analyze the results of colorectal cancer screening in Zhongshan Community，Songjiang District，Shanghai from 2015 to 2017，and to investigate the factors affecting the colonoscopy compliance and abnormal lesions of colonoscopy.Methods　According to the guidelines for colorectal cancer screening in community population in Shanghai，the residents at ages of 50 to 74 years living in the Zhongshan Community，Songjiang District，Shanghai were enrolled from 2015 to 2017.In 2015，all qualified residents were enrolled，and in 2016 and 2017，those with positives screening one year before and those at an age of 50 years at that year were enrolled.All community populations were given primary screening of colorectal cancer by means of risk assessment and fecal occult blood test （FOBT），and the positives were defined as positive results in primary screening，who were advised to receive colonoscopy in designated hospitals.Results　A total of 6 994 residents were screened for colorectal cancer in Zhongshan Community，Songjiang District from 2015 to 2017，including 4 132 residents in 2015，1 604 cases in 2016 and 1 258 cases in 2017．The overall positive rate of the primary screening was 25.25%（1 766
/6 944），the positive rate of FOBT and questionnaire were 5.96% （417/6 994） and 21.12% （1 477/6 994），respectively，and the positive rate of both FOBT and questionnaire was 1.83% （128/6 994）．There were 239 residents （13.53%） receiving colonoscopy，among whom 124 cases （51.88%） were abnormal for colonoscopy.Among the colonoscopic examinations，the highest frequency of detection was seen in adenoma，followed by enteritis.Multivariate Logistic regression analysis revealed that single FOBT positivity 〔OR=42.967，95%CI（22.019，83.844）〕 and FOBT-questionnaire double positivity 〔OR=30.059，95%CI（11.723，77.074）〕 were factors affecting the compliance with positive of first colonoscopy screening （P<0.001），and age 〔OR=3.104，95%CI（1.177，8.189）〕 was a factor affecting the abnormal primary screening results by colonoscopy （P=0.022）．Conclusion　The positive rate of initial colorectal cancer screening in Zhongshan Community，Songjiang District is similar with that in other communities in Shanghai from 2015 to 2017；however，the compliance with colonoscopy is significantly lower in high-risk populations in Zhongshan Community，Songjiang District than in other regions of Shanghai.Positive results in primary screening and age are risk factors affecting the compliance with colonoscopy and abnormal lesions of colonoscopy in community residents.

Key words: Intestinal neoplasms, Screening, Compliance, Shanghai, Songjiang District