Mass screening for colorectal cancer in a population of two million older adults in Guangzhou, China
Mass screening for colorectal cancer in a population of two million older adults in Guangzhou, China
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DOI：
10.1038/s41598-019-46670-2
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发表时间：
2019-07-18
影响因子：
4.6
通讯作者：
Li, Ke
中科院分区：
文献类型：
--
作者：
Lin, Guozhen;Feng, Zhiqiang;Li, Ke
筛查是预防和控制结直肠癌的有效措施。2015 - 2017年，广州市开展了大规模结直肠癌筛查项目。通过公共媒体和手机短信服务的提醒来邀请年龄在50到74岁之间的居民。高危因素问卷调查（HRFQ）和两年一次的粪便免疫化学测试（FIT）作为主要筛查方法，测试结果阳性的个体被转介到指定的医院进行评估结肠镜检查。在这3年中，在2,283,214名合格人口中，有350,581名居民参加了免费的第一阶段筛查。总体而言，91.0%的参与者完成了hrfq和fit。总吸收率为15.4%，随年龄、女性和农村地区的变化而增加。第一阶段筛查阳性率为15.9%，其中HRFQs阳性8.5%，FITs阳性6.2%，HRFQs和FITs阳性1.2%。总共有10600名HRFQs/FITs阳性患者完成了评估结肠镜检查。结肠镜检查的总吸收率为18.9%，随年龄和女性的增加而降低。351例crc和980例晚期腺瘤（AAs）被诊断为阳性预测值（PPV），分别为3.3%和9.2%。在fitt阳性人群中，crc的ppv为4.9%，是hrfq阳性人群（0.5%）的10倍。CRCs和AAs的ppv随年龄和男性增加而增加。局部crc（包括I期和II期）的检出率因筛查提高了68.1%。虽然依从率较低，但CRCs和AAs的ppv较高。应考虑更有效地调动方案的需要和结肠镜检查补贴，以提高遵守情况。
Screening is an effective measure to prevent and control colorectal cancer (CRC). A mass CRC screening programme was conducted in Guangzhou from 2015 to 2017. Public media and reminders from a mobile short message service were used to invite residents aged between 50 and 74 years. A high-risk factor questionnaire (HRFQ) and biennial faecal immunochemical testing (FIT) were chosen as the primary screening methods, and individuals with a positive test result were referred to a defined hospital for an assessment colonoscopy. During the 3 years, 350,581 residents of the total eligible population of 2,283,214 attended the free first stage of screening. In all, 91.0% of the participants finished the HRFQs and FITs. The total uptake rate was 15.4%, which increased with age, female sex, and rural location. There was 15.9% positivity in the first stage of screening, including 8.5% positive HRFQs, 6.2% positive FITs and 1.2% positive HRFQs and FITs. In total, 10,600 individuals with positive HRFQs/FITs completed an assessment colonoscopy. The total uptake rate of colonoscopies was 18.9%, which decreased with age and female sex. Three hundred fifty-one CRCs and 980 advanced adenomas (AAs) were diagnosed with positive predictive values (PPV) of 3.3% and 9.2%, respectively. The PPVs of CRCs in the exclusively FIT-positive population were 4.9%, which was 10 times greater than in the exclusively HRFQ-positive population (0.5%). The PPVs of CRCs and AAs increased with age and male sex. The detection ratio of localized CRCs (including stage I and stage II) increased 68.1% due to screening. Although the compliance rate was low, the PPVs for CRCs and AAs were high. More effective mobilization of the programme's needs and subsidies for colonoscopies should be taken into account to increase compliance.