Analysis Of The Screening Results Of Upper Digestive Tract Cancer In Gansu Province And Establish Of Risk Scorning Model

Objective:Analysis the basic information investigations and endoscopic examination results about 43600 high-risk cases,those have take part in the item of upper digestive tract cancer screening and early detection and treatment in Gansu province in2010 to2015,comprehensively evaluate of the effect and significance.Study the risk factors by single factor and multivariate logistic regression analysis to establish the risk score model,and draw ROC curve to verify its prediction value and reference significance.As to improve the detection rate of early upper digestive tract cancer in Gansuprovince and provide a theoretical reference to the formulate and implement of tumor screening program.Methods:By using cluster sampling method,selected the high-risk group of 40 to 60years old residents in the townships and villages with high incidence of upper digestive tract cancer as the research objects.All participants signed information consent and filled in the basic information survey,which included age,gender,education level,annual income per head,index of body mass,water source,smoking,drinking,drinking tea,food consumption frequency（vegetable,fruit,meat,beans,pickled,fried,hot,mildew）,history of digestive tract disease（gastroenteritis,ulcer,esophagitis,hepatitis,and others）and the information such as family history of cancer.Using endoscopy and iodine staining examination for each screening object.If found any positive or suspicious lesions in the corresponding region,biting biopsy for pathological examination.Collect all of the basic information screening questionnaires,endoscopic diagnosis and pathological diagnosis results.Calculate the detection rate and early diagnosis rate of upper digestive tract cancer,and the relate risk factors of the study subjects were analyzed by statistical methods.Using X² test analysis the related risk factor,and select variables with statistical significance into multivariate logistic regression analysis and finally establish the risk score model,also draw the ROC curve to verify its prediction value.Results:1.The item of upper digestive tract cancer screening and early detection and treatment had a total of 43600 cases in Gansu province in 2010 to 2015.The detection rate was 1.59%,the detection ratio of men and women was 1.90:1.Each part of esophagus,cardia and stomach,the detection rates were 0.51%,0.34%,0.74%,the detection ratio of1.52:1:2.18,the early diagnosis rate was 57.23%,the treatment rate was 87.14%.2.Single factor analysis show that upper digestive tract cancer is influenced by the factors of age,gender,education level,smoking,drinking,drinking tea,pickled food,fried food,hot food,moldy food,history of digestive diseases and tumor history（p<0.05）.3.Selecting the twelve factors with statistical significance of single factor analysis into multivariate logistic regression analysis and finally there are seven factors get into the logistic regression equation,include age,gender,education level,smoking,drinking,pickled food,digestive tumor history（p<0.05）.4.The risk score model:Y=2×men+X₁×age+X₂×education level+3×smoking+2×drinking+2×pickled food+5×digestive tract history,（when 50≤age<60,X₁=5;when60≤age≤69,X₁=7;when the education is high school or above,X₂=-1;when the education is junior high school,X₂=1;when the education is primary school,X₂=2;when had any education,X₂=4）。The area under the ROC curve is 0.704,p<0.05,the Youden index is 0.394,the corresponding critical point is 18,those who scored more than 18 are considered as the higher risk group of upper digestive tract cancer.The sensitivity is 71.5%,the specificity is67.9%.This has certain accuracy and reference value for predicting the risk of upper digestive tract cancer.Conclusion:1.The detection rate of upper digestive tract cancer screening and early detection and treatment item in Gansu province from 2010 to 2015 was 1.59%,the early diagnosis rate was 57.23%,and the treatment rate was 87.14%.2.The upper digestive tract cancer in Gansu province are absolutely influenced by the factors of age,gender,education level,smoking,drinking,pickled food and digestive tumor history（p<0.05）.3.The risk score model has better precision,sensitivity and specificity,which is expected to be used as the risk prediction of upper digestive tract cancer in asymptomatic population in Gansu province.Also,it has a great significance to improve the compliance and detection rate of upper digestive tract cancer in Gansu province,and to further promote the development of national cancer early diagnosis and treatment.