目的：了解城市居民的大肠癌筛查知识、信念及行为现状，探讨居民大肠癌筛查参与意愿的影响因素。方法于2013年7月1—21日，采用完全随机抽样法，在北京陶然亭社区和天桥社区抽取居民600名，其中陶然亭社区330名，天桥社区270名。采用自行设计的访问式问卷，以集中现场调查和入户调查相结合的形式对居民进行调查。问卷内容包括居民的基本情况和大肠癌筛查知信行情况，将问卷填写合格的482名居民纳入研究。结果居民大肠癌筛查知识的中位得分为9（3）分，其中得分较好、一般、较差的居民数分别为48名（占10.0％）、207名（占42.9％）、227名（占47.1％）；平均信念得分为（44±10）分，其中得分较好、一般、较差的居民数分别为245名（占50.8％）、233名（占48.4％）、4名（占0.8％）；在大肠癌筛查参与意愿方面，愿意、不愿意、不确定是否参加免费大肠癌筛查的患者数分别为337名（占69.9％）、107名（占22.2％）、38名（占7.9％）。Spearman秩相关分析显示，知识与信念（rs ＝0.19，P﹤0.05）、知识与参与意愿（rs ＝0.12，P﹤0.05）、信念与参与意愿（rs ＝0.15，P﹤0.05）间均呈正相关关系。不同年龄、文化程度、信念得分居民的大肠癌筛查参与意愿比较，差异有统计学意义（ P﹤0.05）；不同性别、婚姻状况、职业、家庭人均月收入、医疗保险、知识得分居民的大肠癌筛查参与意愿比较，差异无统计学意义（P﹥0.05）。二分类非条件Logistic回归分析显示，性别、年龄及信念得分对居民大肠癌筛查参与意愿的影响有统计学意义（P﹤0.05）。结论城市居民的大肠癌筛查知识、信念、行为水平均有待提高，性别、年龄及筛查信念是居民大肠癌筛查参与意愿的影响因素。应以知信行理论为基础，制定干预措施，提高居民大肠癌筛查的知识和信念水平，从而改善其筛查行为。%Objective To investigate the status of knowledge,attitude and practice of colorectal cancer screening and the influencing factors for the willingness for the screening among urban residents. Methods From July 1 to July 21 in 2013, using complete random sampling method, we enrolled 600 residents from Taoranting Community and Tianqiao Community in Beijing,with 300 residents in Taoranting Community and 270 in Tianqiao Community. Self-designed questionnaire for interview was adopted,and survey was conducted in the form of on-site investigation combined with household investigation. The content of the questionnaire included the basic information and the KAP status of colorectal cancer screening. A total of 482 residents who completed questionnaires well were included. Results The median score of the knowledge of colorectal cancer screening was 9 (3),and the numbers of residents with excellent,medium,and poor scores were 48(10. 0%),207(42. 9%)and 227 (47. 1%)respectively;the average score of attitude was(44 ± 10),and the numbers of residents with excellent,medium, and poor scores were 245(50. 8%),233(48. 4%)and 4(0. 8%);as for the willingness for colorectal cancer screening, the number of patients who were willing,unwilling and uncertain for the colorectal cancer screening free of charge were 337 (69. 9%),107(22. 2%)and 38(7. 9%). Spearman correlation analysis showed that there was positive correlation between knowledge and attitude(rs =0. 19,P﹤0. 05),between knowledge and willingness for the screening(rs =0. 12,P﹤0. 05) and between attitude and willingness for the screening(rs =0. 15,P﹤0. 05). Residents with different ages,education levels and scores of attitude were significantly different in the willingness for the screening of colorectal cancer ( P﹤0. 05 );residents with different genders,marital status,occupation,home monthly income per capita,medical insurance and scores of knowledge were not significantly different in the willingness for the screening of colorectal cancer ( P ﹥0. 05 ) . Binary non -conditional logistic regression analysis showed that gender,age and the score of attitude have significant influence on the willingness for the screening of colorectal cancer(P ﹤0. 05). Conclusion The levels of knowledge,attitude and practice of colorectal cancer screening among urban residents need to be improved. Gender,age and the attitude towards the screening are influencing factors for the willingness for the screening of colorectal cancer. The KAP theory should be taken as the basis,precaution measures should be formulated,the levels of knowledge and attitude of residents about the colorectal cancer screening should be improved,so as to improve the behaviors in colorectal cancer screening.
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