我国城市地区人群癌症筛查需求调查分析

摘要

目的 了解未参加过城市癌症早诊早治项目及其他国家级癌症筛查项目的城市社区居民对癌症筛查服务的接受意愿及对服务模式细化需求,从筛查潜在服务需求方的角度探索癌症筛查工作可持续性的影响要素.方法 基于城市癌症早诊早治项目的16个省份现场,采用方便抽样对当地40～69岁居民开展问卷调查,内容包括筛查服务需求意向等.结果 最终完成合格访谈16 394份,调查对象年龄(53.8±8.0)岁,男性占44.6％.若不考虑费用等因素,4 831名(29.5％)居民对癌症筛查服务没有需求,常见原因包括要等身体出现异常后才行动(61.8％)、所在单位已提供类似体检(36.8％)、自己不先做风险评估而直接去做筛查(33.0％)等.10 795名(65.8％)居民对癌症筛查服务有需求,但对筛查机构类型选择倾向不同:43.7％希望提供筛查的机构是综合性医院,36.5％希望是肿瘤专科医院;居民对于机构级别选择也有差异:61.4％的居民希望提供筛查的机构级别越高越好,36.4％则认为机构达到一定级别即可.关于筛查流程,61.5％未接收过筛查的居民认同“先问卷评估阳性后再临床检查”的模式.结论 大多数居民对癌症筛查服务有需求且倾向筛查机构级别越高越好.应普及癌症筛查知识宣传,并合理引导居民对筛查机构类型及级别的选择期望,建议加强基层筛查能力建设,合理分流居民对筛查机构的选择意愿.%Objective To understand the acceptance and personal demand for cancer screening service among the urban residents who had never been involved in any national level cancer screening programs in China and identify the key factors influencing the sustainability of cancer screening.Methods A questionnaire survey was conducted among the local people aged 40-69 years selected through convenience sampling in 16 provinces of China to collect the general information about their demands for the screening service and others.Results A total of 16 394 qualified questionnaires were completed.The average age of the people surveyed was (53.8 ± 8.0) years,and men accounted for 44.6％.Without concerning the cost,4 831 people (29.5％) had no demands for cancer screening services,the reasons are as follow:they would like to go to see doctors only when they were ill (61.8％);they had already received similar medical examinations (36.8％) and they would like to receive cancer screening directly without pre-health risk assessment (33.0％).Among the people surveyed,10 795 (65.8％) had demands for cancer screening services,but they had choice on the screening settings,43.7％ wanted to receive the service in a general hospitals,while 36.5％ would like to go to cancer-specialized hospitals.As for the level of medical institutes providing cancer screening service,61.4％ of the people surveyed would choose a higher level one,while 36.4％ would choose an ordinary one.On screening procedures,61.5％ of the people surveyed would accept the mode of "clinical examination after questionnaire-assessment".Conclusion Most people surveyed had demands for cancer screening services and they would like to receive the screening services in higher level medical institutes.It is suggested to spread cancer screening know ledge,and strengthen the capability building of screening in grass root medical institutes to attract more people to receive cancer screening.