关键词: 结直肠癌, 人群筛查, 初筛阳性, 结直肠镜顺应性, 影响因素

Abstract: Objective To carry out colorectal cancer screening for permanent residents aged ≥ 45 years in Dongying District, and to explore the compliance of colonoscopy and its influencing factors for those with positive screening results, to provide a scientific basis for improving the colorectal cancer screening of residents. Methods Convenience sampling method was used to select community health service centers in 2 towns and 3 sub-districts within the jurisdiction as volunteer recruitment sites for colorectal cancer screening. Residents aged ≥ 45 years were recruited to conduct colorectal cancer screening and questionnaire surveys. Those who screened positive were further examined by colonoscopy. The results of colorectal screening and colonoscopy compliance of residents were analyzed by descriptive analysis method, and the influencing factors were analyzed by univariate and multivariate analysis methods. Results A total of 1 201 people were included in this study for analysis, including 662 males and 539 females, 372 people aged 45-59 years, 495 people aged 60-69 years, and 334 people aged 70-79 years. A total of 371 cases were positive in the primary screening, including 154 cases of risk factors positive, 298 cases of FOBT positive, and 81 cases of both risk factors and FOBT positive, with a positive rate of 30.89%. Male （OR=3.177）, history of mucus and bloody stool （OR=7.683）, and history of intestinal polyps （OR=5.008） were risk factors for positive screening of colorectal cancer. Among the 371 cases with positive screening results, 121 cases completed colonoscopy, and the compliance rate of colonoscopy was 32.61%. Gender （OR=2.776）, age （OR=0.511, 0.433）, marital status （OR=4.267）, educational level （OR=2.782, 3.916）, and medical insurance （OR=2.743） were influencing factors of colonoscopy compliance in colorectal cancer screening positive patients. Conclusion The positive rate of primary screening for colorectal cancer in the Dongying District of Dongying City is high, so it is necessary to strengthen the screening of colorectal cancer for male individuals with a history of mucus and bloody stool and intestinal polyps. But the compliance to colonoscopy examination of residents is low, especially for female individuals aged 60 and above, who are not married, have a low education level, and have no medical insurance, which should specifically strengthen the health education of this group and improve their colonoscopy compliance.

Key words: Colorectal cancer, Population screening, Positive screening, Colonoscopy compliance, Influencing factor