Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population
Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population
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DOI：
10.1158/1940-6207.capr-10-0377
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发表时间：
2011-10-01
影响因子：
3.3
通讯作者：
Zheng, Shu
中科院分区：
文献类型：
--
作者：
Cai, Shan-Rong;Zhang, Su-Zhan;Zheng, Shu
粪便免疫化学试验（FIT）和高风险因素问卷（HRFQ）相结合的结直肠癌（CRC）筛查在经济和医疗服务不足的人群的性能是不确定的。本研究调查了在中国农村人群中将FIT和HRFQ相结合作为主要筛查方法的CRC筛查方案的性能。2007 - 2009年在嘉善进行了CRC大规模筛查，第一阶段采用FITS和HRFQ，第二阶段采用结肠镜检查。目标人口为三个社区的31 963名居民。HRFQ、FIT和结肠镜检查的依从性分别为84.7%、76.4%和78.7%。FIT对癌、腺瘤、非腺瘤性息肉和晚期肿瘤的检出率分别为2.7%、14.8%、5.9%和8.9%，高于HRFQ的0.5%、9.2%、4.8%和3.8%。FITS与HRFQ对非腺瘤性息肉的检出率无显著性差异。共有41.2%的腺瘤、53.2%的非腺瘤性息肉和29.8%的晚期肿瘤被HRFQ检测到，但被FIT遗漏。FITS联合HRFQ筛查方案对晚期肿瘤的阳性预测值为5.7%，高于单独FITS。男性的晚期肿瘤患病率高于女性。结果表明，在经济和医疗条件较差的人群中，将FIT和HRFQ结合作为主要筛查方法是一种有效的CRC筛查策略。Cancer Prev Res; 4（10）; 1572-9. (C)2011年AACR。
The performance of combining fecal immunochemical tests (FITs) and a high-risk factor questionnaire (HRFQ) in colorectal cancer (CRC) screening in economically and medically underserved populations is uncertain. This study investigated the performance of a CRC screening protocol of combining FITs and an HRFQ as primary screening methods in a rural Chinese population. A CRC mass screening was conducted using FITs and an HRFQ as the first and colonoscopy as the second stage of screening in Jiashan, 20072009. The target population was 31,963 residents in three communities. The compliance was 84.7% for HRFQ, 76.4% for FITs, and 78.7% for colonoscopy. The detected rates of cancer, adenoma, nonadenomatous polyps, and advanced neoplasm were 2.7%, 14.8%, 5.9%, and 8.9% by FITs, which were higher than those by HRFQ (0.5%, 9.2%, 4.8%, and 3.8%, respectively). There was no significant difference in detected rate for nonadenomatous polyps between FITs and HRFQ. A total of 41.2% adenomas, 53.2% nonadenomatous polyps, and 29.8% advanced neoplasms were detected by HRFQ but missed by FITs. Positive predictive value of the screening protocol of combining FITs and HRFQ for advanced neoplasm was 5.7%, which was higher than FITs alone. Men had a higher prevalence of advanced neoplasm than women. Results indicate that combining FITs and HRFQ as primary screening methods is an efficient CRC screening strategy in economically and medically underserved populations. Cancer Prev Res; 4(10); 1572-9. (C) 2011 AACR.