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[目的]评估上海市卢湾区社区大肠癌因症就诊早发现十年工作(1991年7月～2001年6月)的方法和效用。[方法]在卢湾区卫生行政部门领导下 :①建立全区一、二级医院参加的社区大肠癌因症就诊早发现网络 ;②培训医技人员和对有2周以上肛肠症状的病人推行4项常规检查程序(直肠指检 ,乙状结肠镜或结肠镜检查 ,大便隐血试验和X线气钡灌肠双对比造影);③开展社区大肠癌防治健康教育 ;④对大肠癌因症就诊早诊断技术的成本效果进行分析。上海市卫生局、市肿瘤防治研究办公室于1994年起向全市推广卢湾区大肠癌早发现的工作经验。[结果]卢湾区建网后组(n=188)大肠癌初发肛肠症状至确诊的持续时间比建网前组(n=54)缩短 ;卢湾区组和区外对照组南市区组大肠癌的期别构成有显著差异 ;卢湾区组早诊断技术挽回每个DALY(dissabilityadjustedlifeyear)费用折合727.03美元 ,属中等成本费用 ;至1998年 ,上海市大肠癌早期率达18.5% ,较以前的6.5%和7.3%有了提高 ;健康教育干预后 ,居民大肠癌防治知识知晓率有明显提高。[结论]社区大肠癌因症就诊早发现网络是开展大肠癌二级预防工作的有效形式。大肠癌因症就诊早诊断技术是一项符合我国国情的适宜技术。社区大肠癌防治健康教育可能对肛肠病人的就医行为产生干预效果 ,对大肠癌的早
[Objective] To evaluate the method and effect of early discovery of ten-year work (July 1991 ~ June 2001) of community-based colorectal cancer in Luwan District of Shanghai. [Methods] Under the leadership of the administrative department of health in Luwan District: (1) The establishment of community-wide primary and secondary hospitals to participate in the community early detection of colorectal cancer due to illness; (2) training of medical technicians and patients with anorectal symptoms more than 2 weeks 4 Routine examination procedures (digital rectal examination, sigmoidoscopy or colonoscopy, fecal occult blood test and X-ray double contrast barium enema); (3) to carry out community health education in prevention and treatment of colorectal cancer; (4) early diagnosis of colorectal cancer due to disease diagnosis Cost-effectiveness analysis. Shanghai Municipal Health Bureau, City Cancer Research Office since 1994 to promote the city of Luwan District early detection of colorectal cancer work experience. [Results] The duration of initial diagnosis of anorectal colorectal cancer in Luwan District (n = 188) group was shorter than that in the former group (n = 54) Cancer period of the composition of significant differences; Luwan District early diagnosis of technology to restore each DALY (dissabilityadjustedlifeyear) cost equivalent to 727.03 US dollars, is a medium cost; to 1998, Shanghai early colon cancer rate of 18.5%, compared with the previous 6.5 % And 7.3% have improved; health education intervention, residents awareness of prevention and treatment of colorectal cancer has significantly improved. [Conclusion] Early detection of community colorectal cancer due to illness is an effective form of secondary prevention for colorectal cancer. Early diagnosis of colorectal cancer due to disease diagnosis technology is an appropriate technology in line with China’s national conditions. Prevention and treatment of colorectal cancer community health education may have an effect on the medical treatment of anorectal patients have an effect on the early colorectal cancer