基于苏北沿海地区农村上消化道癌机会性筛查分析的胃癌影响因素研究

BackgroundIn recent yearsscreeningearly diagnosis and early treatment of upper gastrointestinal cancer have been successively carried out in various provinces and cities in China. At presentthere are few studies on the screening results of upper gastrointestinal cancer and influencing factors of gastric cancer in coastal area of northern Jiangsu. ObjectiveTo analyze the influencing factors of gastric cancer based on the results of opportunistic screening for upper gastrointestinal cancer in rural population in coastal areas of northern Jiangsuso as to provide a reference for the development of relevant prevention and control strategies. MethodsA total of 8 564 rural subjects at high risk for upper gastrointestinal cancer admitted to the outpatient department of gastroenterology of Lianyungang First People's Hospital and received gastroscopy screening from January 2021 to December 2022 were selectedand divided into the gastric cancer groupn=183and benign gastric disease groupn=366 after matching according to age±2 yearsand gender1:2based on the screening results. The baseline data of the subjects were collectedthe cancer detection rate and cancer early diagnosis rate were calculated. Multivariate Logistic regression analysis was used to explore the influencing factors of gastric cancer in rural population in coastal area of northern Jiangsu. ResultsA total of 521 patients with upper gastrointestinal neoplastic lesions were detectedincluding 183 patients with gastricincluding cardiacancerwith a detection rate of 2.14 %183/8 564and 46 patients with early gastricincluding cardiacancerwith the early diagnosis rate of 25.14%46/183. There was no significant difference in the distribution of different categories of gastric neoplastic lesions in different genders and agesP>0.05. The detection rate of gastricincluding cardianeoplastic lesions in males5.14%195/3 795was higher than females2.05%98/4 769and the difference was statistically significantχ2=60.807P<0.001. There were significant differences in the detection rate of gastricincluding cardianeoplastic lesions among different age groupsχ2=163.216P<0.001and early diagnosis rate of gastric cancer among different age groups χ2=69.349P<0.001among which the early diagnosis rate was the highest in the group of 40-49 years37.50% and the lowest in the group over 80 years10.53%. Multivariate Logistic regression analysis showed that junior high school education or belowOR=4.00195%CI2.0297.890P<0.001smokingOR=3.71095%CI2.1276.470P<0.001salty tasteOR=1.77795%CI1.0672.957P=0.027frequent spicy dietOR=2.14795%CI1.2973.556P=0.003preference for red meatOR=1.78795%CI1.0183.139P=0.043frequent consumption of leftoversOR=2.45295%CI1.5383.912P<0.001irregular dietOR=2.42095%CI1.4204.124P=0.001and helicobacter pyloriHppositive/previously positiveOR=3.78595%CI2.3945.984P<0.001were risk factors for gastric cancer in rural populationwhile regular physical exerciseOR=0.59895%CI0.3590.996P=0.048and frequent consumption of fresh fruitsOR=0.53195%CI0.3280.860P=0.010were protective factors for gastric cancer in rural populationP<0.05. Conclusion Opportunistic screening of upper gastrointestinal cancer can significantly improve the detection rate of upper gastrointestinal cancer in Coastal Area of Northern Jiangsu. Junior high school education and belowsmokingmultiple unhealthy food habits and Hp positive/previously positive are risk factors for gastric cancer in rural population. Future efforts should focus on improving the awareness of gastric cancer prevention among rural male and elderly population in the region.