大腸癌是相當常見且死亡率高的癌症,台灣近年來大腸癌的發生率呈上升趨勢,顯示大腸癌的嚴重性是不容小覷。因此,如何致力於大腸癌的預防及篩檢策略是個很重要的議題。由於我國政府提供未滿40歲民眾每3年1次免費健康檢查的服務,因此,若能找出與大腸異常相關性高的健康檢查項目,則透過健康檢查的結果,可能可以及早發現大腸異常問題性,以便進一步作詳細的檢查,如糞便潛血及大腸鏡檢查,使能達到預防保健的目的,以維護身體的健康。 本研究運用多變量分析方法,探討健檢項目彼此間的關聯性,再將相關性高的健檢項目群聚成組,並找出與大腸異常相關的重要健檢項目或項目群組,然後分析各重要健檢項目檢驗值的可能危險範圍。 本研究結果發現,若將大腸鏡檢查結果分為正常與異常2類時,重要的健檢項目有年齡、鹼性磷酸、紅血球沈降率、三酸甘油脂以及甲狀腺刺激素等5項,這些項目預測大腸異常異常的準確率達72.4%;若將大腸鏡檢查分為正常、無特殊異常發現、一般有瘜肉、增生性瘜肉以及腺瘤為5類時,這些項目重要的健檢項目有年齡、X13’群組以及游離型四碘甲狀腺素等3項,這些項目預測大腸異常的準確率只有35.6%。當上述本重要健檢項目的檢驗值超出正常範圍,則可接受較詳細的大腸眼查,以及早發現可能的大腸異常問題。
Colorectal cancer is quite common and has high mortality, the incidence of colorectal cancer in Taiwan has increasing trend in recent years. Hence, the seriousness of colorectal cancer should not be underestimated. Therefore, the prevention and screening of colorectal cancer is a very important issue. Since the government of Taiwan provides free health examination service for elder adult people, it is worthwhile to explore the critical items of health examination which are correlated with the colon abnormalities. Then, the early detection of colon abnormalities through health examination can improve the preventive health care. In this study, multivariate analysis method is used to investigate the correlation between health examination items. The highly correlated health examination items are clustered as groups to increase the independency of the health examination items (or items clusters). Then, the discriminate analysis is applied to explore the critical health examination items (or items clusters) which are significantly correlated with colon abnormalities. The results of this research show that accuracy rate of abnormality prediction is 72.4% when the colonoscopy results are divided into 2 class (normal and abnormal), where the critical health examination items are founded as age, alkaline phosphatase, erythrocyte sedimentation rate, triglycerides, and thyroid-stimulating hormone significance.