Screening For Early Diagnosis And Treatment Of Upper Digestive Tract Cancer In Wuwei City Of Gansu Province And Its Influencing Factors

Objective:To evaluate the screening results of early diagnosis and early treatment of upper digestive tract cancer and its influencing factors in Wuwei,Gansu Province,and to provide scientific basis for the establishment of a prevention and treatment system for early diagnosis and early treatment of upper digestive tract cancer in high incidence area of upper digestive tract in Gansu Province.Methods:From Wuwei City,one of the high incidence areas of upper digestive tract ca?ncer in Gansu Province,8929 people from 20 natural villages of Liangzhou District were selected as screening population by using multi-stage cluster sampling method,which has a good basis for screening and tumor registration.The method of iodine staining under gastroscope and indicative multi-point biopsy technique were used to screen the upper gastrointestinal cancer.The incidence,mortality,detection rate,early diagnosis rate and treatment rate were compared with the national level and Wuwei city in different years.To evaluate the effectiveness of screening for upper gastrointestinal cancer;in addition,the population with pathologically diagnosed upper gastrointestinal cancer after endoscopic screening was used as the case group: according to the 1:2 matching formula Method to choose the control group conducted a case-control study,and Research on related factors questionnaire tract cancer in two groups were on digestion.The relationship between the multi factor Logistic regression analysis of disease and influencing factors,so as to analyze the main risk of upper digestive tract cancer incidence area factor.Results:(1)A total of 8929 subjects were included in the study from 2012 to 2016.2537 cases were checked and eliminated by physical examination,and 6392 cases were actually screened by gastroscope,which were not recommended for further gastroscopy.The screening rate was 71.59%.A total of 151 patients with upper digestive tract cancer were diagnosed by endoscopy and pathological biopsy from 2012 to 2016.The total detection rate was 2.36%(151 / 6392),which was significantly higher than the average detection rate of1.64% of upper digestive tract cancer in China.Of 151 cases of upper gastrointestinal cancer detected,124 were early cases,with an early diagnosis rate of 82.12%,higher than the national average rate of early diagnosis of upper digestive tract cancer 73.45%.144 patients with upper gastrointestinal cancer were treated.The treatment rate reached 95.36%,which is higher than the national average of treatment rate of upper digestive tract cancer.The incidence of upper digestive tract cancer in Wuwei from 2012 to 2016 has decreased by4.81%,but still higher than the incidence of upper digestive tract cancer in China(36.07/100000).The mortality rate has decreased by 0.61% compared with 2015,the same as in 2015.The mortality rate of cancer of upper digestive tract in China was higher than that in China.(2)Study on the influence factors of upper gastrointestinal cancer: the two Logistic regression analysis on Influencing Factors of upper gastrointestinal cancer showed that are exposed to hazardous substances occupation(OR=2.783,95%CI:2.484-3.119),smoking(OR=1.332,95%CI:1.228-1.445),drinking(OR=2.111,95% CI:1.887-2.360),eating salted food(OR=1.169,95%CI:1.102-1.239),hot food(OR=1.426,95%CI:1.368-1.487),fried foods(OR=2.460,95%CI:2.107-1.873),coarse food(OR=1.483,95%CI:1.405-1.565),Contrary to type A personality(OR=1.196,95%CI:1.139-1.256)poor interpersonal relationships(OR=1.472,95%CI:1.394-1.554),in the long-term mental depression status(OR=1.603,95%CI:1.290-1.992),disease history(OR=1.187,95%CI:1.092-1.291),family history of cancer(OR=1.452,95%CI:1.336-1.579),infection of Helicobacter pylori(OR=3.375,95%CI:3.058-3.725)were risk factors for upper gastrointestinal cancer,while the consumption of fresh vegetables(OR=0.735,95%CI:0.671-0.806),fresh fruit(OR=0.412,95%CI:0.379-0.448),meat and milk(OR=0.809,95% CI:0.767-0.853),garlic(OR=0.960,95%CI:0.956-0.963)were protective factors of upper digestive tract cancer.Conclusion:(1)The detection rate and the rate of early diagnosis and treatment of cancer has increased in Wuwei during 2012-2016 on digestion,not only can be found in the early upper gastrointestinal cancer patients with early lesions,but also through early treatment,strengthen the two grade prevention,the mortality of cancer patients with upper digestive tract decreased.(2)Smoking,drinking,eating pickled food,hot food,fried food,hard food,contrary to type A personality,harmful substances in occupational contact,poor interpersonal relations,long-term mental depression,have a history of illness,In the family history of cancer,Helicobacter pylori infection was the risk factor of upper digestive tract cancer.Consumption of fresh fruits and vegetables,garlic and meat and egg milk were all protective factors of upper digestive tract cancer.Reduce the incidence of upper gastrointestinal cancer.