| Background:the development direction of our country’s health services in21century is community health service(CHS). CHS has an irreplaceable role for maintaining the health of residents. The newest medical reform program officially announced status and task of CHS and made clear the direction of the next step building of CHS. To strengthen CHS we need government support, rational allocation of health resources and more publicity promoting people to change their ideas. We also need to establish "two-way referral" system which has complementary advantages, introduce and train highly qualified talents, make general medical practitioner as the backbone, inspire people by policy instruments. Community tumor prevention and treatment which is an important content of community services has a growing concern. Tumor is one of the key disease in community prevention and treatment. With the acceleration of social urbanization, industrialization, environment pollutants and chemicals is increasing, coupled with the impact of unhealthy lifestyles and behavior, cancer has become one of the major diseases endanger human life and health. In various diseases, mortality of malignant tumor ranked first in the city, second in rural areas. The aging of China’s urban residents is a serious problem. With the progress of urbanization, chronic non-communicable diseases, especially malignant tumors, is an increasingly serious threat of the physical and mental health of the residents. In the background of vigorously promote the new medical reform in our country, Community tumor prevention and treatment which is an important content of community services has a growing concern. Tumor community prevention and treatment units established in the community is an important work in the community cancer prevention and treatment work. Nasopharyngeal carcinoma (NPC) is a kind of tumor which has an obviously popular feature. The incidence of NPC in China has significant regional differences and is high in the southern and eastern, espacially Guangdong, Guangxi, Fujian, Hainan, Hunan etc. Because the hidden lesions and the early symptoms are not obvious. NPC is often misdiagnosed and missed, resulting in advanced cases the majority. It’s the key to early diagnosis, early treatment and to secure the best treatment and prognosis that screening NPC prone areas. Guangxi is located in the NPC high-incidence area, Aim at this situation, the establishment of a community prevention and treatment unit of NPC high-risk groups make some useful attempts. Numerous studies suggest that EB virus(EBV) infection and NPC is closely related. In this research, we consider the people whose EB virus VCA-IgA antibody (=1∶5) as NPC high-risk groups.Object:1. Establish NPC high-risk groups community prevention and treatment unit in Guangxi, promote cancer prevention knowledge on community, screen natural populations, mobilize the NPC high-risk groups which obtained by screening to regularly follow-up review, enhance the level of population health knowledge.2. Investigate the role of the establishment of prevention and treatment unit in the screening of NPC high-risk groups, work out for a feasible, economic and social benefits well programs for community cancer screening.3. Analyse EB virus VCA-IgA antibody infection situation of community resident. Investigate the relationship between virus infection and gender, age. Provide a basis for later NPC screening.Methods:1. object of study:the Guangxi community employees and residents.2. the choice of venue:select a community medical institutions in Guangxi.3. preliminary work:In support of the leader associated with the institution,we send trained professionals to the department of physical examination. Povide anti-cancer materials about health education, Mobilize the community employees and residents who would have a physical examinate in the institution take a screening of NPC.4. Screening work:Collect peripheral blood samples of the natural populations examined in the community health care institution by professionals in the department of physical examination, register information, separate the blood samples, detect the EB virus VCA-IgA antibody, register the complete information of the VCA-IgA antibody-positive population, send the results to the department of physical examination which notice them a regular follow-up review.Results:1. By screening community population of11584cases, we have established a cohort contain681cases of NPC high-risk persons, and provide them anti-cancer materials and guidance about health education.2. The screened11584cases of natural population have complete data. Establish health records in the community medical institution and take a regular follow-up review. Preliminary establish the community prevention and treatment unit about NPC high-risk groups in Guangxi.3. In the11584cases, VCA-IgA antibody of681cases are positive(681/11584,5.88%). EB virus VCA-IgA antibody-positive detection rate were no statistically differences between men and women (P>0.05) but were statistically differences between different age-groups (P<0.05).4. The established community prevention and treatment unit about NPC had screened11584people. Screening indicator (VCA-IgA) was positive in681cases. All of the681cases were managed as NPC high-risk groups.Conclusion:Understand the epidemiological characteristics of community oncology, help to carry out targeted tumor community prevention and treatment work. In this study, based on community health institutions, Preliminary establish the community prevention and treatment unit about NPC high-risk groups. The establishment of the prevention and treatment unit for community NPC high-risk population screening provides a convenient. Through the unit, the community residents could receive health education of cancer prevention. And can also help them to overcome the fear of cancer, master the basic knowledge of cancer prevention, and establish a good lifestyle and habits, improve the consciousness and ability of the cancer prevention. Actively participate in the screening of tumor, and regularly participate in the examination. For tumor prevention and treatment of health education in the community is of practical significance. To improve residents’knowledge of cancer prevention and treatment, improve the early diagnosis rate, there is much work to do. On this basis, should be placed on high-risk groups in the community were followed up and other related work, especially for residents over40years of age, having family history and the family members of the8cases of NPC patients previously diagnosed. They are the focus groups of cancer prevention and health education. |
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