Evaluation of optimized sequential screening program of colorectal cancer in current China
10.3760/cma.j.issn.0253-9624.2014.11.015
- VernacularTitle:我国现行大肠癌优化序贯筛查方案评价
- Author:
Qilong LI
1
;
Lingling YU
;
Feng XUE
;
Wanli MA
;
Kaiyan YAO
Author Information
1. 314100,浙江省嘉兴市嘉善县肿瘤防治所
- Keywords:
Colorectal neoplasms;
Sensitivity and specificity;
Optimized sequential screening
- From:
Chinese Journal of Preventive Medicine
2014;(11):995-1000
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the sensitivity and specificity of optimized sequential screening program of colorectal cancer , and provide evidence for the further optimization of colorectal cancer screening program.Methods Using cluster sampling method , 4 administrative villages were selected from Jiashan county as a census district in 2011 to 2013.Volunteers of 40 to 74 years old in the census were recruited , and tested by both optimized sequential screening ( including questionnaire survey and fecal occult blood test ) and colonoscopy for colorectal cancer.Sensitivity and specificity of different screening methods were calculated, respectively.Results A total of 2 607 volunteers took both simultaneously screening and colonoscopy at the same time.20 colorectal cancer cases , 85 advanced adenoma cases , 271 non-advanced adenomas cases , and 141 non-adenomatous polyps cases were detected.Sensitivity of optimized sequential screening for colorectal cancer , advanced adenomas , and non-advanced adenomas were 70.0%( 14/20 ) , 57.6%(49/85) and 36.5%(99/271), specificity was 68.7%(1 776/2 587), 69.2%(1 746/2 522) and 68.9%(1 610/2 336), respectively.Sensitivity of the fecal occult blood test of colorectal cancer , advanced adenomas and non-advanced adenomas were 70.0%( 14/20 ) , 47.1%( 40/85 ) and 26.6%( 72/271 ) , specificity was 79.4%(2 053/2 587), 79.9%(2 014/2 522) and 79.6%(1 860/2 336).The sensitivity of fecal occult blood test and those of optimized sequential screening for colorectal cancer , advanced adenomas was not significent (χ2 =0.00,1.91,all P values >0.05).Sensitivity of questionnaire survey of colorectal cancer, advanced adenomas and non-advanced adenomas were 10.0%(2/20), 14.1%(12/85), 12.9%(35/271), specificity was 87.6%(2 266/2 587), 87.7%(2 211/2 522), 87.6%(2 046/2 336). There were no significant difference between non-advanced adenomas.The sensitivity of advanced adenomas and non-advanced adenomas showed no significant decline when the following six term were removed from screening programs: chronic diarrhea , chronic constipation , mucus or bloody history , history of chronic appendicitis or appendectomy surgery , chronic cholecystitis or gallbladder surgery , adverse events in the history of life, while the sensitivity of colorectal cancer remained nearly the same 70.0%(14/20),52.9%(45/85),31.4%( 85/271 ) (χ2 =0.38, 1.61, all P values >0.05 ).Conclusion Current optimized sequential screening programs for colorectal cancer in China have a high sensitivity and specificity .However , further optimization is viable and necessary.
