40% of cancers occur in rural areas. What are the problems faced by rural people in cancer prevention and treatment?
In China, an average of more than 11100 people are diagnosed with new cancer every day, but the prevention and treatment of cancer in rural areas is still faced with many problems. The average score of core knowledge of cancer prevention and treatment in rural areas is 57.7. The awareness rate of lung cancer, liver cancer, gastric cancer and esophageal cancer is the highest in rural areas. The awareness rate of tumor symptoms of mass and pain in rural population is more than 90%. The top five tumors screened out in rural population were lung, upper digestive tract, blood system, urinary system, straight colon and so on. It shows that these people do not pay attention to the clinical symptoms of suspected pre-tumor. "the distance and the quality of medical services are the main considerations for rural cancer patients in the first diagnosis hospitals. Rural residents generally believe that the diagnosis and treatment level of doctors in grass-roots medical institutions is not high, but also promote more rural patients to seek medical treatment at the county level and above first. Due to the lack of understanding of cancer-related symptoms in rural patients.
Zhou Qing, member of the CPPCC National Committee and director of the Cancer Hospital of Guangdong Provincial people's Hospital, said that 40% of the country's new malignant tumors are in rural areas every year.
According to the latest cancer report released by the National Cancer Center in the Journal of the National Cancer Center (JNCC), an average of more than 11100 people in China are diagnosed with new cancer every day, and nearly 6600 people die of cancer.
At present, the clinical treatment of cancer has made a great breakthrough, the life expectancy of many cancer patients is longer than before, and the cure rate has also been improved. Even so, cancer still requires early detection, early diagnosis and early treatment. Urban people have long been exposed to the extensive popularization of science, but the prevention and treatment of cancer in rural areas is still faced with many problems.
Cancer prevention concept
The results of the survey show that the average score of core knowledge of cancer prevention and treatment of residents in rural areas of China is 57.7, and the cognitive score of most residents is between 40,70 and 70, and the level of knowledge of cancer prevention is low. Moreover, the older the age, the lower the level of cancer prevention knowledge, and the level of women is significantly lower than that of men, especially middle-aged and elderly women.
The rural population has the highest awareness rate of lung cancer, liver cancer, gastric cancer and esophageal cancer, reaching 96.03%, probably because these cancers are the main types of cancer in rural areas of our country, but the awareness rate of breast cancer, cervical cancer and colorectal cancer is less than 50%. Can not keep up with the changing trend of the cancer spectrum in our country.
In terms of symptoms, the awareness rate of tumor symptoms of lumps and pain among rural people is more than 90%, but the recognition rate of changes in stool habits or dysfunction (such as dysphagia, defecation difficulty, etc.) is less than 30%.
In addition, although most residents are willing to undergo an annual physical examination, 55% of the residents can only afford the medical examination fee of less than 100 yuan if they want to spend their own money on the physical examination, and only less than 5% of the residents can afford the medical examination fee of more than 500 yuan.
At present, China's basic medical insurance system is mainly to ensure the treatment of diseases, there is no coverage of preventive screening. If cancer screening can be included in health insurance and residents' out-of-pocket expenses for screening can be reduced, it will greatly increase residents' willingness to screen, thus increase the rate of early truth. in the long run, it can save medical expenses and reduce the economic burden of individuals, society and the country.
Definite diagnosis condition
From the perspective of screening, the top five tumors screened out in rural population were lung, upper digestive tract, blood system, urinary system, straight colon and so on. Males were higher than females, and the clinical symptoms of pretumor were more obvious. among them, the symptoms of "inexplicable cough persisting", "abdominal distension", "stool thinning and increasing frequency" accounted for the top three, indicating that these people did not pay attention to the clinical symptoms of suspected pretumor. It is also suggested that the propaganda and education on early detection of tumor need to be strengthened.
The education level of rural people is relatively low, health awareness is poor, there are widespread smoking, drinking, eating leftovers and pickled products, as well as like high-fat, high-cholesterol diet, drinking and other unhealthy living habits, which have a serious impact on health. The smoking rate of people over the age of 60 is 30.26%, exceeding the national level.
First-visit hospital
Rural cancer patients choose the first medical institutions mainly consider the distance and the quality of medical services, county-level hospitals are their first choice for medical treatment.
Rural residents generally believe that the diagnosis and treatment level of doctors in primary health care institutions is not high, which may lead to diagnosis delay. With the improvement of rural traffic conditions, it also promotes more rural patients to seek medical treatment at the county level and above first.
Due to the lack of understanding of cancer-related symptoms in rural patients, when they go to grass-roots medical and health institutions such as villages and towns, they are often treated as common diseases and can not be diagnosed in time because of the lack of medical technology and examination equipment. as a result, the disease was found in the middle and late stage, and the treatment was difficult and the prognosis was poor.
Some elderly patients have found physical discomfort in the early stage of the disease, but they think that going to the hospital will trouble their children, worry about spending money to increase the burden on others, and go to the village clinic or drugstore to buy medicine for treatment. finally, when they go to the hospital, they are often in the terminal stage of the disease.
Treatment condition
It is generally believed that there are many high-quality medical resources in cities, and most patients will choose the nearest third-class and first-class hospitals. And a considerable number of rural cancer patients will also go to urban hospitals, hospitalization rather than county-level hospitals. Non-local patients often account for more than half of the oncology departments of tertiary and first-class hospitals.
However, hospitalization in the city means going back and forth between the city and the countryside many times, and patients have to go to the city for medical treatment and return to their hometown for recuperation. Among them, rural patients more often choose to see the nearest doctor during the period of non-radiotherapy and chemotherapy, and return to the urban hospital for radiotherapy and chemotherapy in an average of about 14-30 days.
All these show that in the case of rising cancer incidence in rural areas, we should increase popular science publicity, enhance rural people's awareness and knowledge of cancer prevention, increase investment in grass-roots medical institutions, establish a remote diagnosis and treatment system between urban and rural areas, and, most importantly, improve medical security for rural people, universal screening, early detection and early treatment, money can be treated.
Regular screening for 6 kinds of cancer
The "expert consensus on the basic items of physical examination" issued by the Chinese Medical Association introduces the screening of lung, breast, cervical, colorectal, gastric and prostate cancers:
lung cancer. The screening population was over 50 years old, with family history of lung cancer, smoking history, cough, chest pain, blood in sputum, long-term low fever and so on. The main screening methods were lung low dose CT and tumor markers such as neuron specific enolase (NSE), cytokeratin 19 fragment (CY-FRA21-1), carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and new marker gastrin precursor releasing peptide (ProGRP).
breast cancer. The screening population was women over 35 years old, with family history of breast cancer, breast disease, marriage and childbearing history, menstrual history, breast pain unrelated to menstrual cycle, abnormal nipple secretions and so on. The main screening methods were breast ultrasound, mammography, tumor markers CA-153, CA-125, CEA.
Cervical cancer. The screening population was female over 21 years old, with family history of cervical cancer, menstruation, reproductive history, unclean sexual life history, abnormal leucorrhea, vaginal bleeding and so on. The main screening methods were cervical ultrathin cytology (TCT), HPV test, tumor markers SCC and CEA.
colorectal cancer. The screening population was over 50 years old, family history of colorectal cancer, history of chronic colitis and intestinal polyps, lower abdominal pain, hematochezia, mucous stool, stool frequency and so on. The main screening methods were anal examination, fecal occult blood, colonoscopy, air-barium double contrast radiography, tumor markers CEA, CA-199, CA-242.
Stomach cancer. The screening population was over 50 years old, with family history of gastric cancer, gastric ulcer, gastrointestinal polyp, abdominal pain, diarrhea, weight loss, tarmac stool and so on. The main screening methods were gastroscopy, air-barium double contrast radiography, Helicobacter pylori examination, determination of gastrin and gastrin, tumor markers CA72-4 and CEA.
Prostate cancer. The screening population was male over 45 years old, with recurrent frequent urination, urgent urination and hematuria, especially the family history of prostate cancer and chronic inflammation. The main screening methods are prostate palpation, prostate ultrasound, tumor markers such as prostate specific antigen (PSA) and free prostate specific antigen (fPSA). # Cancer #