西安地区肝癌高危人群筛查依从性调查及影响因素研究

doi:10.12183/j.scjpm.2022.1205

摘要/Abstract

摘要： 目的调查西安地区≥40岁肝癌高危人群筛查依从性,并探讨其相关影响因素。方法采用方便抽样方法抽取西安市≥40岁且在当地居住时间≥3年的居民参与肝癌高危人群评估,并对评估结果为肝癌高危的居民进行血液甲胎蛋白检测和腹部超声检查,采用描述性分析和多因素分析方法对筛查结果、筛查依从情况及其影响因素进行分析。结果本研究对西安地区36 187名常住居民进行肝癌高危人群筛查,其中6 514例居民评估为肝癌高危,肝癌高危率为18.00%。其中男性高危者比例高于女性,99.08%为汉族,96.65%为已婚,年龄≥60岁人群的肝癌风险更高,多为初中及以上文化程度,88.12%的BMI值为18.5~27.9 kg/m²,58.40%有吸烟史,43.71%有饮酒习惯,44.00%有家族肿瘤史,71.17%伴有慢性丙型肝炎,97.19%伴有慢性乙型肝炎。6 514例肝癌高危人群中有3 192例参加肝癌筛查,肝癌筛查依从性为49.00%。多因素Logistic回归分析结果显示年龄（OR=0.444）、BMI（OR=0.694、0.820）、吸烟（OR=1.177）、饮酒（OR=1.178）、伴有慢性乙型肝炎（OR=1.266）、有家族肿瘤史（OR=1.579）、职业（OR=4.204）、锻炼次数（OR=0.774）、家庭人均月收入（OR=1.790）、定期参加检查（OR=2.542）是筛查依从性的影响因素。结论西安地区肝癌高危人群筛查依从性整体偏低,影响筛查依从性的重要因素较多,可通过加强健康教育,增强医护患三方沟通来进一步完善筛查机制,提高筛查效率。

关键词: 肝癌高危人群, 筛查依从性, 现状调查, 影响因素

Abstract: Objective To investigate the compliance of screening among high-risk individuals of liver cancer ≥ 40 years old in Xi'an, and explore its influencing factors. Methods The residents ≥ 40 years old and living in Xi'an for ≥ 3 years were selected by convenient sampling method to participate in the evaluation of high risk for liver cancer, and the residents who were assessed as high risk of liver cancer were tested for blood alpha-fetoprotein and abdominal ultrasound, and the results of screening, compliance with screening, and its influencing factors were analyzed by descriptive analysis method and multivariate analysis method. Results In this study, 36 187 residents in Xi'an City were screened for high risk of liver cancer, of which 6 514 residents were assessed as high risk of liver cancer, and the high-risk rate was 18.00%. Among them, the proportion of male high-risk persons was higher than that of females, 99.08% were Han nationality, 96.65% were married, and the risk of liver cancer was higher in people ≥ 60 years old, most of whom had junior high school education or above, 88.12% had a body mass index （BMI） value of 18.5-27.9 kg/m2, 58.40% had a history of smoking, 43.71% had a habit of drinking, 44.00% had a family history of tumor, 71.17% had a history of chronic hepatitis C, and 97.19% had a history of chronic hepatitis B. Among 6 514 high-risk individuals of liver cancer, 3 192 cases participated in liver cancer screening, and the compliance of screening was 49.00%. Multivariate Logistic regression analysis showed that age （OR＝0.444）, BMI （OR＝0.694,0.820）, smoking （OR＝1.177）, alcohol consumption （OR＝1.178）, chronic hepatitis B （OR＝1.266）, family history of tumor （OR＝1.579）, occupation （OR＝4.204）, times of exercise （OR＝0.774）, average monthly household income （OR＝1.790）, and regular examination （OR＝2.542） were the influencing factors of screening compliance. Conclusions The screening compliance of high-risk individuals of liver cancer in Xi'an is generally low, and many important factors affect screening compliance. We can further improve the screening mechanism and improve the screening efficiency by strengthening health education and strengthening communication between doctors, nurses, and patients.

Key words: High-risk individuals of liver cancer, Screening compliance, Status survey, Influencing factor

中图分类号:

R195

李静, 张曦, 杜粉静, 刘小静, 路德艳, 贺婷, 陈红梅. 西安地区肝癌高危人群筛查依从性调查及影响因素研究[J]. 华南预防医学, 2022, 48(10): 1205-1209.

LI Jing, ZHANG Xi, DU Fen-jing, LIU Xiao-jing, LU De-yan, HE Ting, CHEN Hong-mei. Compliance and its influencing factors of screening among high-risk individuals of liver cancer in Xi 'an[J]. South China Journal of Preventive Medicine, 2022, 48(10): 1205-1209.

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