Study On Gastrointestinal Cancer Screening Results And Influencing Factors Among Urban Residents In Hefei

Objectives The study was aimed to 1)understand the health status of digestive tract and the distribution and severity of precancerous lesions of digestive tract in Hefei,Anhui based on the analysis of results of program for cancer screening.2)Analyze the influencing factors of the health status of different part of digestive tract,understand the development rule of lesion and the possibility of cancerous changes,and identify the key risk factors of lesion in different part.Methods The study selected,using clustered-randomization approach,7 districts in Hefei and then selected 2 or 3 communities from each of the district.40-70 years old of eligible residents in all the selected districts were recruited to administer a face-to-face interview using a structured questionnaire first.And then the high risk individuals identified through the questionnaire assessment were promoted to receive clinical examinations and the questionnaire about chronic diseases.The data derived were analyzed using SPSS 17.0 software.Methods used in the data analysis included descriptive analysis,chi-square test,Wilcoxon rank sum test,and logistic regression modeling.Results 1)there are 1277 residents who completed upper digestive tract endoscope examination and the questionnaire about chronic diseases.The detection rate of esophageal lesions increased with age;the rate of 40-49 years old group,50-59 years old group and 60-70 years old group were 13%,18.4% and 21.2% respectively.The pathological changes of esophagus in males(21.2%)were higher than that in females(15.0%).There was no significant difference in the detection rate of cardiac and gastric fundus lesions between subgroups of age,gender,and education level and body mass index.The lesion rate of corpora ventriculi increased with age,being 23.2%,31.2% and 32.1% respectively for 40-49,50-59 and 60-70 years.The lesion rate of gastric angle of males was 2 times that of females(male was 17.2%,female was 8.2%).Different BMI levels had different lesion rate in pylorus,the rates of normal BMI,overweight and obesity were 9.38%,5.08% and 9.40%,respectively.2)The most common pathological change of esophagus and cardiac part was erosion.The top three lesions of gastric fundus and corpora ventriculi were congestion,polyps and edema.Congestion was the most common lesion in both gastric angle and gastric antrum,the incidence in gastric antrum was as high as 88.89%.3)The highest score of lesion in esophagus,cardiac part and gastric fundus was 4,the highest proportion of score was 1.Corpora ventriculi,gastric angle and gastric antrum had the highest score of 5.4)The lesion score of cardiac part had statistical associations with diabetes.There was also a statistical association between lesion score of gastric fundus and recurrent stomach pain.The lesion score of corpora ventriculi was associated with high blood fat,insomnia and gastric polyp.There was a statistical association between score of gastric angle and the history of gastric ulcer and hepatitis;the higher the score,the higher the proportion of history of gastric ulcer.The lesion score of gastric antrum was associated with hypertension,high blood fat and history of gastric ulcer.5)There was significant association between esophageal lesion score and eating fried food,salty food,drinking,smoking frequently.The lesion score of corpora ventriculi was associated with regular alcohol consumption and the higher the score,the higher the rate of regular drinking.The score of gastric angle and gastric antrum had associations with regular smoking and drinking.There was an association between score of duodenum and irregular diet habits.6)The left colon and rectum were the most likely parts of lesions,the incidence increased with the increase of age and BMI.7)The risk factors for colorectal lesions include age,BMI,history of hypertension,history of intestinal polyps and recurrent constipation.Conclusions The most likely parts to be found with pathological changes in the upper digestive tract were esophagus and gastric antrum.The incidence was affected by various history of illness and diet and behavior habits.The results point out high risk groups and key parts for cancer screening.And it is feasible to select higher risk group through investigating history of illness and diet and behavior habits.2)Left colon and rectum were most prone to lesions,suggesting the key parts for colonoscopy.The analysis of association between colorectal lesions and risk factors hints that it is feasible to select high risk group through history of illness but the role of various diet and behavior habits in colorectal cancer screening.