医药学论文：上消化道恶性肿瘤“两步筛查法”在城乡结合区的课题研究

【摘要】癌症的早期发现、早期诊断及早期治疗作为我国提高五年生存率及降低死亡率的主要策略之一，本研究以雨花台区七个街道35岁以上人群14000人为研究对象，通过理论模型设计、功能需求调查、《上消化道肿瘤筛查量表》的制定以及通过对两个街道3000人调查和对筛查出246例高危人群开展胃镜检查和病理诊断的预试验的结果，开展了上消化道恶性肿瘤病例"两步筛查法"在城乡结合部的课题研究，从而发现上消化道早期肿瘤病例，提高癌症的早诊早治率，同时对调查对象开展宣教、随访，并评价用"两步筛查法"在城乡结合区对上消化道恶性肿瘤高危人群的预警、早期诊断和干预的效应，建立一套城市地区和城郊结合地区比较经济适用的上消化肿瘤筛查、早诊早治以及预防干预的模式，为全国同类地区肿瘤筛查和预防干预提供科学依据。
【Abstract】the early detection of cancer, early diagnosis and early treatment as our country increase the five year survival rate and lower mortality as one of main strategy, this research take the Yuhuatai area seven street 35 people over the age of 14000 as the research object, through theoretical model design, function demand investigation," upper digestive tract tumor screening scale" formulation as well as through to two street in 3000 and to screening out of 246 cases high risk population in gastroscopy and the pathological diagnosis of the test results, carried out on the malignant tumor of digestive tract case" two step screening method" in the combination of urban and rural research, which found in early upper gastrointestinal tumors a case, improve cancer early diagnosis and early treatment rate, at the same time to carry out propaganda and education, follow-up survey and evaluation, with" two step screening method" in urban and rural area of upper digestive tract cancer in high-risk populations of early warning, early diagnosis and intervention effect, establish a set of city region and in outskirts of economical and applicable upper gastrointestinal tumor screening, early diagnosis and early treatment and prevention intervention model, similar to the areas of tumor screening and preventive interventions to provide a scientific basis.
肿瘤是当今严重威胁人类健康和社会经济发展的重大疾病。自20世纪70年代恶性肿瘤、心脑血管等慢性非传染性疾病逐步取代传染性疾病，成为主要的死亡原因以来，由恶性肿瘤引起的死亡和医药费用等负担问题日益突出。中国肿瘤登计处2004年恶性肿瘤发病资料显示，肺癌、胃癌、食道癌、肝癌、乳腺癌是威胁我国居民健康的主要恶性肿瘤，江苏省是全国恶性肿瘤高发地区，发病率居于全国前列，肿瘤死亡居于全省死因构成的首位(29.71%,)．死亡率达l8.5／l0万，全省每年约14万人口因肿瘤死亡。雨花台区2006至2010年死因分析显示，全区每年约400例因肿瘤死亡．恶性肿瘤死因顺位在全死因病种中处于第一或第二位，恶性肿瘤占全死因减寿顺位的第一位，因恶性肿瘤死亡的病例约占总死亡病例的40%左右。上消化道恶性肿瘤是恶性肿瘤的重要组成部分，早诊、早治是提高上消化道恶性肿瘤防治效果的有效措施。《中国癌症预防与控制规划纲要(2004-2010年)》将胃癌、食管癌列入了重点防治癌症范畴。但目前全国推广的上消化道恶性肿瘤筛查方法耗费大量的人力、财力和物力，城郊结合区肿瘤发病不断提高的趋势情况下，建立一套城市地区和城郊结合地区同