| Objective: Work on the observation of malignant tumor detection rate and segment features in population of our physical examination center. Explore related factors which affecting the detection rate of malignant tumors. Make a standard of the physical examination to improve the positive ratio of malignant tumor screening. Provide the scientific basis for the malignant tumor early diagnosis and early treatment.Methods: The study subject is the health examination population of Hebei Medical University 4th hospital physical examination center during January 2013 to December 2015. All of them had no known history of malignant tumor, severe diseases and acute infectious diseases. All of them do the examination by the given physical examination plan. The selected samples were the doubting tumor population(by Imaging examination and Medical Laboratory test, and need further examination or reexamination 6 months later). Collate personnel information of the doubting tumor group. Setup an electronic health file. Follow up by full time personnel. Inform the patients of high-risk and help them to further examinations. And based to the doctor’s command, follow up at 1 week, 2 weeks, 1month,and 3-6 months after the examinations. The follow-up items include diagnostic result and treatment situation. The staff would explain the health problems to the doubting tumor people who didn’t come to return visit. The health education of the prevention and cure of tumor, and reservation referral time should be done at the same time. The major way of follow-up are telephone and short-massage, while QQ and We Chat can be the new way if they are needed. The final results were recorded and analyzed. Observe the detection rate and distribution characteristics of patients with malignant tumor. Explore the related factors affecting the detection rate. Establish a standardized health examination service model. The collected data is processed by Excel and statistically analyzed by SPSS19.0 software. The enumeration data is expressed by rate and percentage. χ2test was used to compare among different groups, P < 0.05 as the difference has statistical difference.Results:1 There are 19979 people participated in the health examination in this study. Male 8486(42.47%), female 11493(57.53%). Among them, 30-39 years old, 40-49 years old, 50-59 years of age accounted for the largest proportion. Respectively 24.86%, 20.26%, 18.20%. The proportion of occupational distribution of medical staff is larger(44.62%).2 There are 879 patients with suspected tumor were screened out in this study. The follow-up rate of suspected personnel increased from 25.93% to 90.94% by gradually improve the follow-up system and the implementation of digital medical information management. There are 82 patients with malignant tumor were detected. The positive rate was 9.33%. The miss follow-up rate decreased from 74.07% to 9.06%. There are 163 patients with doubting tumor were lost to follow-up. The total loss rate was 18.54%. The reasons for the loss of follow-up were mainly related to the cognitive level of the subjects, and the unclear physical examination information of the subjects.3 There are 82 patients with malignant tumor were detected. The total positive rate was 4.10‰. In the age stratified comparison, ≥70 years old was the highest detection rate group. Sex comparison, the ratio of male and female with malignant tumors was 1:2.28, and the detection rate of female was higher than that of male. Occupational comparison, medical personnel and other occupational detection rate is higher than the civil servant. There were statistically significant differences in age, gender and occupation(P<0.05).4 The detection of malignant tumor mainly occurs in the endocrine system, respiratory system, reproductive system and urinary system. The thyroid cancer, lung cancer, breast cancer, cervical cancer and renal cell carcinoma detection rate is higher, respectively for 1.5‰, 1.25‰, 0.96‰, 0.44‰, 0.20‰. That is higher than local malignant tumor incidence rate.5 In the 82 cases of detected malignant tumor, 12 cases without clear clinical stage, 70 cases of clinical staging information. 64 patients were clinical stage I. Constituent ratio was 78.05%. Among them, the constituent ratio of thyroid cancer in clinical stage I was 83.33%, the constituent ratio of lung cancer in clinical stage I was 76.00%.6 Comparison of screening methods of the 82 detected malignant tumors, 47 cases were detected by ultrasound, 22 cases were detected by CT, 6 cases were detected by laboratory examination(liquid based cytology and tumor markers), 3 cases were detected by radiation, 2 cases were detected by breast blood-oxygen functional image technology,2 cases were detected by surgery.Conclusion:1 Improve the information collection of the subject, follow-up of the suspected persons of the tumor and strengthen the health education of the subject is the key to the discovery of the early malignant tumor.2 Malignant tumors in the healthy population of the total positive rate was 4.10‰. 78.05% of them is clinical stage I. The detection rate of thyroid cancer, lung cancer, breast cancer, cervical cancer, renal cancer is higher than the morbidity in the same area3 It is beneficial to improve the detection rate of malignant tumors by set up the physical examination items and strengthen the professional training of medical doctors. |
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