癌症篩檢結果及其影響因子探討 -以某縣市口腔癌篩檢為例

A Study of Cancer Screening Result and Influence Factors – Case of a County Oral Cancer Screening

陳效君(Hsiao-chun Chen)

指導教授 ： 詹前隆

元智大學/資訊學院/資訊管理學系/碩士(2011年)

https://doi.org/10.6838/YZU.2011.00185

摘要

本研究設計採橫斷性研究法，使用次級資料分析，以回溯性方式研究，以男性發生率最高的癌症-口腔癌為例，探討本縣參加口腔癌篩檢與社會人口學、不健康行為及醫療服務利用的相關性，並進而探討不同的篩檢地點(科別)對於口腔癌篩檢結果為陽性與診斷結果的影響關係。利用邏輯斯迴歸分析結果發現，不論在性別、年齡、嚼檳榔、吸菸、篩檢地點及檢查醫師科別，對於篩檢結果皆有影響關係。
在性別上，男性口腔異常的比例是女性口腔異常的2.024倍；在年齡上，每增加一歲口腔異常的比例多增加1.004倍；在吸菸及嚼食檳榔上，嚴重程度每增加一級口腔異常的比例分別多增加1.126倍及1.393倍；在篩檢的地點上，醫療院所篩檢出陽性的比例是社區或職場檢測站的2.011倍；在篩檢醫師的科別上，篩檢出陽性的的比例由高排至低為牙科、耳鼻喉科，其次為其他科別之醫師。
以不同篩檢地點及篩檢科別分別與口腔癌確診結果之交叉分析皆有顯著性相關，並得知醫療院所的初篩正確率高於社區或職場。而不同科別的篩檢醫師，其初篩陽性之再確診正確率也會有所不同，耳鼻喉科與牙科的初篩正確率均高於其他科甚多。可提供衛生機關對於篩檢醫師的在職教育及實務教育之參考依據，以提升口腔癌篩檢品質及鑑別診斷的能力，俾利增進國民健康、節制癌症醫療費用之目標。

關鍵字

口腔癌篩檢 ； 癌症篩檢結果

並列摘要

This retrospective study used the cross-sectional analysis with secondary data. By taking the highest incidence male cancer - oral cancer as an example, this study probed into the relationahip between the social demography, unhealthy-behaviors, health services utilization and the screening result of oral cancer in a county in northern Taiwan. The relationship between the sites of screening, doctors’ expertise and the diagnostic results were also investigated. By Logistic Regression Analysis, we found that gender, age, betel nut chewing and smoking are all related to positive oral cancer screening result. The screening sites and doctors’ expertise also linked to the result.
In gender, the oral abnormality ratio of male is 2.024 times of female. In age, the oral abnormality ratio increases 1.004 times with one-year increasing. In smoking and betel nut chewing, the oral abnormality ratio increases 1.126 and 1.393 times separately with one-level rising of severity. In screening site, the positive screened ratio in hospital is 2.011 times of screened in community or workplace medical station. In doctors’ expertise, the positive screened ratio ranked from high to low are dentist , E.N.T doctors, and other expertise.
By cross-table analysis, there is significant relationship between screening doctors’ expertise and confirming diagnosis of oral cancer screening. The accuracy of initial oral cancer screening in hospital is higher than screening in community and workplace. The screening outcomes by different expertise doctors are also different. The accuracy of confirming diagnosis by dentists and E.N.T doctors are both much higher than by the other expertise doctors. This can provide health institution the reference evidence of screening doctors’on-job training and practical education to enhance the quality of oral cancer screening and the capability of differential diagnosis. Eventually, it could benefit to achieve the goals of the health promotion and cancer medical expense reduction.

並列關鍵字

Oral Cancer Screening ； Cancer Screening Result

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