上海地区结直肠癌高危人群结肠镜筛查依从性及其影响因素分析

doi:10.12183/j.scjpm.2026.0258

摘要/Abstract

摘要： 目的调查上海地区结直肠癌高危人群结肠镜筛查依从性及其危险因素,为提高结肠镜筛查及结直肠癌预防提供参考依据。方法采用整群分层随机抽样,于2024年1—12月期间选取上海地区8个社区的常住居民为研究对象,开展结直肠癌高危人群评估调查及结直肠癌筛查,分析高危人群的结肠镜筛查依从率,并通过单、多因素logistic回归分析方法分析结肠镜筛查依从性的影响因素。结果共3 925名上海地区社区居民完成问卷调查和粪便隐血试验（FOBT）筛查,结直肠癌高危人群检出率为27.29%（1 071/3 925）。1 071例结直肠癌高危人群中,354例接受结肠镜筛查,筛查依从率为33.05%。结直肠癌筛查知识总得分为（12.5±3.6）分;结直肠癌健康信念总评分为（120.2±16.7）分;肠癌筛查厌恶量表总评分为（77.8±16.7）分。多因素logistic回归分析表明：文化程度大专及以上（OR=2.445）、家庭平均月收入≥5 000元（OR=1.644）、婚姻状况为在婚（OR=1.906）、一级亲属结直肠癌史（OR=3.343）、恶性肿瘤史（OR=4.158）、肠道息肉史（OR=2.643）、黏液血便（OR=1.956）、定期体检（OR=4.707）、感知风险高（OR=6.753）、之前谈论过筛查（OR=2.173）、自评健康状态差（OR=2.203）以及结直肠癌筛查知识（OR=1.709）、感知大肠癌易感性（OR=1.478）、结肠镜检查厌恶（OR=0.264）和健康自觉性（OR=0.603）是结直肠癌高危人群的结肠镜筛查依从性相关因素（均P<0.05）。结论上海地区社区居民结直肠癌高危人群结肠镜筛查依从性仍有待继续提升,需针对结直肠癌高危人群特征进行正确引导和宣教,缓解居民对结肠镜筛查的抵触情绪和顾虑,加强结直肠癌筛查力度。

关键词: 结直肠癌, 高危人群, 结肠镜检查, 依从性, 相关因素

Abstract: Objective To investigate colonoscopy screening adherence and its associated risk factors among high-risk individuals for colorectal cancer (CRC) in Shanghai, providing an evidentiary basis for enhancing colonoscopy screening rates and CRC prevention. Methods Utilizing a cluster stratified random sampling method, permanent residents from eight communities in Shanghai were selected as study participants between January and December 2024. A survey was conducted to assess high-risk status for CRC, and screening was implemented. The colonoscopy screening adherence rate among the high-risk population was analyzed. Univariate and multivariate logistic regression analyses were employed to identify factors influencing adherence. Results A total of 3 925 community residents in Shanghai completed the questionnaire and fecal occult blood test (FOBT), yielding a CRC high-risk detection rate of 27.29% (1 071/3 925). Among the 1 071 high-risk individuals, 354 underwent colonoscopy, corresponding to a screening adherence rate of 33.05%. The mean total score for CRC screening knowledge was (12.5±3.6). The mean total score for health beliefs regarding CRC was (120.2±16.7), and the mean total score on the Colorectal Cancer Screening Aversion Scale was (77.8±16.7). Multivariate logistic regression analysis indicated that the following factors were significantly associated with colonoscopy screening adherence in the high-risk population (all P<0.05): educational attainment of college level or higher (OR=2.445), average monthly household income ≥5 000 yuan (OR=1.644), married status (OR=1.906), a first-degree relative with a history of CRC (OR=3.343), a personal history of malignant tumors (OR=4.158), a history of intestinal polyps (OR=2.643), presence of mucous and bloody stools (OR=1.956), regular physical examinations (OR=4.707), high perceived risk (OR=6.753), prior discussion of screening (OR=2.173), poor self-rated health status (OR=2.203), CRC screening knowledge (OR=1.709), perceived susceptibility to colorectal cancer (OR=1.478), aversion to colonoscopy (OR=0.264), and health consciousness (OR=0.603). Conclusion The adherence to colonoscopy screening among high-risk individuals in Shanghai communities requires further improvement. It is imperative to provide targeted guidance and health education tailored to the characteristics of the high-risk population to alleviate aversion and concerns regarding colonoscopy, thereby strengthening CRC screening efforts.

Key words: Colorectal neoplasms, High-risk populations, Colonoscopy, Adherence, Correlated factors

中图分类号:

R195.4

杨钟灵, 毛晶珏, 顾英, 周云庆. 上海地区结直肠癌高危人群结肠镜筛查依从性及其影响因素分析[J]. 华南预防医学, 2026, 52(3): 258-263.

Yang Zhongling, Mao Jingjue, Gu Ying, Zhou Yunqing. Adherence to colonoscopy screening and its influencing factors among high-risk populations for colorectal cancer in Shanghai[J]. South China Journal of Preventive Medicine, 2026, 52(3): 258-263.

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