Comparison of application effects of colonoscopy, fecal immunochemical test and a novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population.
10.3760/cma.j.cn112150-20211203-01113
- Author:
Yun Xin KONG
1
;
Dong DONG
1
;
Hong Da CHEN
2
;
Min DAI
2
;
Lang ZHUO
3
;
Pei An LOU
4
;
Ting CAI
5
;
Si Ting CHEN
5
;
Jian Qiang PAN
5
;
Yi Huan GAO
3
;
Hang LU
5
;
Zong Mei DONG
4
;
Hong Ying ZHAO
1
;
Xiao Hu LUO
1
;
Guohui CHEN
1
Author Information
1. Cancer Prevention and Control Office, Xuzhou Cancer Hospital, Xuzhou 221000, China.
2. Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
3. School of Public Health, Xuzhou Medical University, Xuzhou 221004, China.
4. Chronic Disease Prevention and Control Department, Xuzhou Center for Disease Control and Prevention, Xuzhou 221000, China.
5. School of Management, Xuzhou Medical University, Xuzhou 221004, China.
- Publication Type:Randomized Controlled Trial
- MeSH:
Aged;
Colonoscopy;
Colorectal Neoplasms/pathology*;
Early Detection of Cancer;
Feces;
Female;
Humans;
Male;
Mass Screening;
Middle Aged;
Occult Blood
- From:
Chinese Journal of Preventive Medicine
2022;56(8):1074-1079
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the application effect of the colonoscopy, fecal immunochemical test (FIT) and novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population. Methods: From May 2018 to April 2019, 4 280 subjects aged 50-74 were recruited from Gulou district, Yunlong district and Quanshan district of Xuzhou. They were randomly assigned to the colonoscopy group (n=863), FIT group (n=1 723) and novel risk-adapted screening approach group (n=1 694) according to the ratio of 1∶2∶2. For the novel risk-adapted screening approach group, after the risk assessment, high-risk subjects were invited to undergo colonoscopy and low-risk subjects were invited to undergo FIT examination. All FIT positive subjects were invited to undergo colonoscopy. Colonoscopy participation rate [(the number of colonoscopies completed/the number of colonoscopies invited to participate)×100%], detection rate of colorectal lesions [(the number of diagnosed patients/the number of colonoscopies completed)×100%], colonoscopy resource load (the number of colonoscopies completed/the number of diagnosed advanced tumors) and FIT resource load in each group were calculated and compared. Results: The age of all subjects was (61±6) years old, including 1 816 males (42.43%). There was no statistically significant difference in the socio-demographic characteristics of the subjects in different screening groups. The colonoscopy participation rate was 22.60% (195/863) in the colonoscopy group, 57.04% (77/135) in the FIT group, and 33.94% (149/439) in the novel risk-adapted screening approach group, respectively. The colonoscopy participation rate was higher in the FIT group than in the colonoscopy group and the novel risk-adapted screening approach group (P<0.001). The colonoscopy participation rate of novel risk-adapted screening group was significantly higher than the colonoscopy group (P<0.001). The detection rates of advanced tumors were 6.67% (13/195), 9.09% (7/77) and 8.72% (13/149), respectively, and the difference was not statistically significant (P>0.05). The colonoscopy resource load (95%CI) was 15 (13-17) in the colonoscopy group, 11 (9-14) in the FIT group and 11 (10-13) in the novel risk-adapted screening approach group, respectively. Among them, the colonoscopy resource load of high-risk individuals in the novel risk-adapted screening approach group was 12 (9-15). FIT resource loads (95%CI) were 207 (196-218) and 88 (83-94) in the FIT group and the novel risk-adapted screening approach group. Conclusion: The combined application of risk-adapted screening approach and FIT may have a good application effect in colorectal cancer screening.
