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[目的]了解闵行区“六癌”(大肠癌、胃癌、肝癌、肺癌、乳腺癌、宫颈癌)早发现效果及其影响因素。[方法]对1999~2011年早发现登记队列中确诊的“六癌”与肿瘤登记系统中同期非队列人群确诊的“六癌”确诊期别、生存率及生存质量进行比较。[结果]“六癌”早期率,1年、3年、5年生存率和生存质量队列组均优于非队列组。基于社区的早发现模式效果好于基于医疗机构的早发现模式。影响患者生存的因素为:发病年龄、性别、家族史、手术性质、转移、患≥2个肿瘤、未经早发现干预,OR分别为:1.03、1.13、2.17、1.21、1.88、1.76、1.71。粘液性囊性肿瘤风险较高(OR=1.22,P=0.02),腺癌、导管癌及鳞癌与上皮肿瘤相比死亡风险相当。患肠癌、胃癌、肝癌及肺癌较宫颈癌的死亡风险分别为:1.55、2.55、3.99、4.07,乳腺癌为宫颈癌死亡风险的0.66倍。[结论]两种早发现模式均有一定成效,基于社区的肿瘤早发现模式效果较优。“六癌”早发现、早诊断、早治疗,提高根治率是降低死亡风险的关键,尤其需要加强肝癌及肺癌的早诊早治工作。
[Objective] To understand the early detection effect and its influencing factors of Minhang District “six cancers ” (colorectal cancer, gastric cancer, liver cancer, lung cancer, breast cancer and cervical cancer). [Methods] The diagnosed “Six-Carcinoma” in the registration cohort and the diagnosed “Six-Carcinoma” in the same period non-cohort of the cancer registration system from 1999 to 2011 were compared. The survival rate and quality of life were compared. [Results] The early rate, the one-year, the three-year, the five-year survival rate and quality of life of the six-cancer group were better than those of the non-cohort group. Community-based early detection is better than medical-based early detection. Factors affecting the survival of patients: age, gender, family history, surgical nature, metastasis, with more than 2 tumors, without the intervention of early detection, OR were: 1.03,1.13,2.17,1.21,1.88,1.76,1.71. Mucinous cystic tumors have a higher risk (OR = 1.22, P = 0.02). Adenocarcinomas, ductal carcinomas, and squamous carcinomas are at comparable risk of death from epithelial tumors. The risk of death from colon cancer, stomach cancer, liver cancer and lung cancer is 1.55, 2.55, 3.99, 4.07, respectively, and breast cancer is 0.66 times the risk of cervical cancer death. [Conclusion] Both of the two patterns of early detection have some effects, and community based patterns of early detection of tumors are more effective. Early detection, early treatment and improvement of cure rate are the keys to reduce the risk of death. In particular, early diagnosis and treatment of liver cancer and lung cancer need to be strengthened.