Factors associated with adherence to colonoscopy among individuals who were positive in the preliminary screening for colorectal neoplasms.
Factors associated with adherence to colonoscopy among individuals who were positive in the preliminary screening for colorectal neoplasms.
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DOI：
10.1002/cam4.4730
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发表时间：
2022-11
期刊：
影响因子：
4
通讯作者：
Fang, Yu-Jing
中科院分区：
文献类型：
--
作者：
Li, Ji-Bin;Ke, Keng-Jian;Zhang, Wei-Li;Wang, Ling-Yan;Wu, Yan-Ping;Weng, Fan;Tian, Huan;Qiu, Zhi-Yu;Li, Yin;Lin, Shi-Yong;Ye, Mei-Xian;Ou, Qing-Jian;Gong, Cheng-Hua;Lu, Zhen-Hai;Pan, Zhi-Zhong;Wan, De-Sen;Peng, Jian-Hong;Fang, Yu-Jing
关键词：
本研究旨在调查在中国社区结直肠癌筛查项目中初步筛查阳性的参与者中与结肠镜检查依从性相关的潜在因素。本研究分析了6971名社区居民中的1219名的数据，这些居民在结直肠肿瘤的初步筛查阶段通过经过充分验证的高危因素问卷（HRFQ）或粪便免疫化学试验（FIT）被确定为阳性病例。显示依从结肠镜检查的患者定义为在结肠直肠肿瘤初步筛查中获得阳性结果，随后根据需要接受结肠镜检查的患者。使用logistic回归模型评估了HRFQ中的社会人口统计学因素、生活方式行为、糖尿病史、体重指数（BMI）和风险因素与结肠镜检查依从性的相关性。在1219名初步筛查阳性的参与者中，参与者报告的前五位风险因素是慢性便秘（25.9%），便血（23.5%），一级亲属中的CRC家族史（22.1%），慢性腹泻（21.8%）和息肉史（16.6%）。初步筛查阳性的参与者中约有14.2%报告了三个或三个以上的危险因素，根据HRFQ和FIT均为阳性的参与者中的比例为26.2%。在所有初步筛查为阳性的参与者中，多变量结果显示，（OR = 1.58，95% CI：1.12，2.25，p = 0.01），有慢性腹泻（OR = 1.34，95% CI：1.00，1.78，p = 0.047），且FIT阳性（对于根据HRFQ为阴性但根据FIT为阳性的患者，OR = 1.60，95% CI：1.21，2.10，p < 0.001; OR = 2.12，95% CI：HRFQ和FIT均为阳性的患者（OR：0.33，2.78，p = 0.002）更有可能坚持结肠镜检查，而有癌症史的参与者（OR：0.50，95% CI：0.31，0.79，p = 0.003）不太可能坚持结肠镜检查。仅根据HRFQ检测为阳性的参与者的结果与根据HRFQ或FIT检测为阳性的所有参与者的结果相似。然而，在仅根据FIT检测呈阳性的参与者中，我们只发现那些已婚的人，（OR = 2.52，95%CI：1.08，5.90，p = 0.033）有较高的几率坚持结肠镜检查，而那些有糖尿病史（OR = 0.35，95% CI：0.13，0.96，p = 0.042）不太可能坚持结肠镜检查。我们的研究结果提供了证据，支持制定量身定制的干预策略，旨在提高结直肠肿瘤高危人群对结肠镜检查的依从性。在支持系统和卫生政策中，应考虑与坚持结肠镜检查相关的障碍和促进因素。然而，需要进一步精心设计的前瞻性研究来证实我们的发现。目前，我国结肠镜筛查的参与率仍然很低。我们找出与结直肠肿瘤初筛阳性个体的结肠镜检查依从性相关的因素。
This study aimed to investigate the potential factors associated with adherence to colonoscopy among participants who were preliminarily screened positive in a community‐based colorectal cancer screening program in China. This study analyzed data from 1219 out of 6971 community residents who were identified as positive cases by the well‐validated high‐risk factor questionnaire (HRFQ) or fecal immunochemical test (FIT) in the preliminary screening stage for colorectal neoplasms. Patients showing adherence to colonoscopy were defined as those who received positive results in a preliminary screening for colorectal neoplasms and later received a colonoscopy examination as required. The associations of social‐demographic factors, lifestyle behaviors, history of diabetes, body mass index (BMI), and risk factors in the HRFQ with adherence to colonoscopy were evaluated using logistic regression models. Among 1219 participants who preliminarily screened positive, the top five risk factors reported by the participants were chronic constipation (25.9%), hematochezia (23.5%), family history of CRC in first‐degree relatives (22.1%), chronic diarrhea (21.8%), and history of polyps (16.6%). Around 14.2% of participants who preliminarily screened positive reported three or more risk factors, and the proportion was 26.2% among participants who were positive according to both HRFQ and FIT. Among all participants who were preliminarily screened positive, the multivariable results showed that those who were married (OR = 1.58, 95% CI: 1.12, 2.25, p = 0.01), had chronic diarrhea (OR = 1.34, 95% CI: 1.00, 1.78, p = 0.047), and had a positive FIT (OR = 1.60, 95% CI: 1.21, 2.10, p < 0.001 for patients who were negative according to HRFQ but positive according to FIT; OR = 2.12, 95% CI: 1.33, 2.78, p = 0.002 for patients who were positive for both HRFQ and FIT) were more likely to adhere to colonoscopy, while participants with a history of cancer (OR: 0.50, 95% CI: 0.31, 0.79, p = 0.003) were less likely to adhere to colonoscopy. The results among participants who were tested positive according to only HRFQ were similar to those among all participants who were tested positive according to HRFQ or FIT. However, among participants who were tested positive according to only FIT, we only found that those who were married (OR = 2.52, 95% CI: 1.08, 5.90, p = 0.033) had a higher odds of adhering to colonoscopy, while those with a history of diabetes (OR = 0.35, 95% CI: 0.13, 0.96, p = 0.042) were less likely to adhere to colonoscopy. Our findings provide evidence supporting the development of tailored interventional strategies that aim to improve adherence to colonoscopy for individuals with a high risk of colorectal neoplasms. Both barriers and facilitators associated with adherence to colonoscopy should be considered in supportive systems and health policies. However, further well‐designed prospective studies are warranted to confirm our findings. For the participation rate of colonoscopy screening is still disappointingly low in China. We find out the factors associated with colonoscopy adherence among individuals who were positive in the preliminary screening for colorectal neoplasms.
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DOI：
10.1056/nejmoa1301969
发表时间：
2013-09-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Nishihara R;Wu K;Lochhead P;Morikawa T;Liao X;Qian ZR;Inamura K;Kim SA;Kuchiba A;Yamauchi M;Imamura Y;Willett WC;Rosner BA;Fuchs CS;Giovannucci E;Ogino S;Chan AT
通讯作者：
Chan AT
影响因子：
4.6
作者：
Lin, Guozhen;Feng, Zhiqiang;Li, Ke
通讯作者：
Li, Ke
影响因子：
3.3
作者：
Cai, Shan-Rong;Zhang, Su-Zhan;Zheng, Shu
通讯作者：
Zheng, Shu
影响因子：
3.8
作者：
Chuck KW;Hwang M;Choi KS;Suh M;Jun JK;Park B
通讯作者：
Park B
影响因子：
7.7
作者：
Rex, Douglas K.;Boland, C. Richard;Robertson, Douglas J.
通讯作者：
Robertson, Douglas J.