【摘要】 目的:利用新型农村合作(新农合)医疗系统数据,描述河南省滑县食管癌、贲门癌和非贲门胃癌基本流行特征及其患者选择就诊机构的特点。方法:对2011年滑县新农合医疗系统数据进行标准化筛选,明确食管癌、贲门癌和非贲门胃癌首诊病例。计算3种肿瘤的年发病率以及中国及世界人口标化发病率及截缩率。利用χ2检验比较不同类型患者就诊医疗机构的构成比差异。结果:2011年河南省滑县农村地区食管癌、贲门癌和非贲门胃癌发病率分别为50.52/10万、9.63/10万和7.00/10万。男性发病率均高于女性,男性和女性食管癌和非贲门胃癌以及女性贲门癌发病率随年龄逐渐升高。不同肿瘤患者在医疗机构选择方面的差异有统计学意义(χ2=19.53,P=0.003),但均以县级医院比例为最高。不同性别对医院级别的选择差异无统计学意义(χ2=2.14,P=0.543)。高年龄患者选择低级别医疗机构就诊的比例较高,而低年龄患者更倾向于到高级别医疗机构就诊。结论:河南省滑县农村地区属于食管癌高发区,但贲门癌和非贲门胃癌发病率水平较低。应进一步完善新农合医疗政策以确保高年龄组患者获取医疗服务和卫生资源的公平性。更多还原

【Abstract】 Objective:To describe the epidemiological characteristics of esophageal cancer,cardiac cancer and non-cardiac gastric cancer in Hua County,Henan Province,and to analyze the patients’ choiceof hospital by using the data from local NCMS(New Rural Cooperative Medical System) database.Methods:The newly diagnosed cases of esophageal,cardiac and non-cardiac gastric cancers were acquired from the NCMS database of Hua County through a standardized screening procedure.Crude incidence rates,the world’s and China’s population-standardized incidence rates and truncated incidence rates were calculated.χ2-test was used to evaluate the differences of proportions of the patients’ choice of hospital.Results:The crude incidence rates of esophageal,cardiac and non-cardiac gastric cancers were 50.52/105,9.63/105 and 7.00/105,respectively,in rural Hua County,Henan Province,in 2011.Higher incidence rates of these three kinds of cancers were observed in males.The incidence rates of esophageal and noncardiac gastric cancers in males and females as well as that of cardiac cancer in females increased with age.Although the hospital choice was significantly different among the patients with various cancers(χ2=19.53,P=0.003),county-level medical facilities were predominant in all three kinds of cancer patients.The hospital choice between the male and female patients was not significantly different(χ2=2.14,P=0.543).The elderly patients tended to choose lower level of medical facilities while the younger patients chose higher level of medical facilities.Conclusion:Hua County of Henan Province is a high-risk region of esophageal cancer.The policy of NCMS should be further improved to ensure equality of the medical service and resource accessibility for rural elder cancer patients.更多还原