Colorectal Cancer Screening With High Risk-Factor Questionnaire and Fecal Immunochemical Tests Among 5, 947, 986 Asymptomatic Population: A Population-Based Study

Zhang, Mingqing; Zhao, Lizhong; Zhang, Yongdan; Jing, Haoren; Wei, Lianbo; Li, Zhixuan; Zhang, Haixiang; Zhang, Yong; Zhu, Siwei

doi:10.3389/fonc.2022.893183

Cited by 12 publications

(18 citation statements)

References 45 publications

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“…gynaecologists or general practitioners) recommend colonoscopy surveillance during consultation with someone having Lynch syndrome. The third identified predictor of non-compliance concerned low and medium educational level (OR 7.41 and OR 2.82, respectively), which is consistent with other studies on CRC screening [ 31 – 33 ]. Further research should explore why this sub-set of individuals shows lower compliance rates, and which strategies could enhance their compliance.…”

Section: Discussionsupporting

confidence: 88%

Colonoscopy surveillance in Lynch syndrome is burdensome and frequently delayed

et al. 2023

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Individuals with Lynch syndrome have an increased colorectal cancer risk, hence, biennial colonoscopy surveillance is recommended. We aimed to investigate patients’ perception and preferences regarding surveillance, and to further explore compliance behaviour. Individuals with Lynch syndrome received a validated survey evaluating experiences of their three most recent colonoscopies. Individuals were non-compliant to surveillance if the interval between colonoscopies differed ≥ 6 months from the recommended interval. In total, 197 of 291 (68%) invited individuals returned the survey. They mostly underwent colonoscopy biennially (99%), under mild sedation (79%) and with bowel preparation performed by Moviprep® (99%). Surveillance was perceived as impacting quality of life in 21%, and as moderately to extremely burdensome in 57%, particularly in those below age 40. To lower the burden, patients prioritised improvements in volume and taste of bowel preparation, laxation-related bowel movements, waiting times, and a more personal and respectful approach of endoscopic staff. Additionally, many individuals (60%) would favour less-invasive surveillance modalities such as biomarkers. In total, 28% of individuals had delayed colonoscopy surveillance, predominantly for patient-related reasons. An additional 10% considered quitting/postponing surveillance. Upon multivariable analysis, patient-related delay was associated with low and medium education, history of ≤ 4 colonoscopies and having no hospital recall-system. Colonoscopy surveillance in Lynch syndrome is often experienced as burdensome, and frequently delayed. We identified determinants of surveillance behaviour in this population, and present potential interventions to reduce the burden and non-compliance rates.

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Section: Discussionsupporting

confidence: 88%

Colonoscopy surveillance in Lynch syndrome is burdensome and frequently delayed

et al. 2023

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“…With regard to the percent with positive family history in FDR (7.8%), it was lower than that from most western countries, but was comparable with or even higher than other reports from China (2.7%-5.9%) [ 26 , 27 ], with some studies only reporting an overall positive rate of high-risk assessment questionnaire, ranging from 3.3% to 15.0% [ 4 , 28 – 30 ]. This could be partly caused by the wide geographical, economic and racial variation in in the pattern of cancer [ 2 , 31 , 32 ], which might be associates with multiple factors, such as genetic, lifestyle, and environmental factors.…”

Section: Discussionsupporting

confidence: 62%

Modifiable lifestyle factors have a larger contribution to colorectal neoplasms than family history

et al. 2022

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Background Screening recommendations for colorectal cancer (CRC) are mainly based on family history rather than lifestyle risk factors. We aimed to assess and compare risk factors for colorectal neoplasm (CRN) and evaluate trends in neoplasm detection rates during the three rounds of screening from 2012 to 2020 in Tianjin, China. Methods This study was based on 89,535 first-recorded colonoscopies in Tianjin CRC screening program, 2012–2020. Of these, 45,380 individuals with complete family history and lifestyle factors were included for population attributable fraction (PAF) estimation. Results The overall detection rate of nonadvanced adenomas, advanced adenomas and CRC was 39.3%, 5.9% and 1.5%, respectively. The PAFs of current smoking, alcohol consumption, physical activity, higher BMI and family history of CRC, respectively, were 8.9%, 2.6%, 1.9%, 5.8%, and 1.1% for males with nonadvanced CRN; 12.3%, 7.3%, 4.9%, 7.2%, and 0.8% for males with advanced CRN; 3.4%, 0.4%, 2.1%, 7.8%, and 0.7% for females with nonadvanced CRN; and 4.3%, 0.2%, 8.2%, 8.5%, and -0.6% for females with advanced CRN. The PAFs of selected lifestyle factors were 19.9% for males with nonadvanced CRN, 29.0% for males with advanced CRN, 9.7% for females with nonadvanced CRN and 13.8% for females with advanced CRN. Conclusions Modifiable lifestyle factors, including smoking, alcohol consumption, physical activity and BMI, have a larger contribution to CRN than family history of CRC. Our findings will provide references for developing guidelines of CRC prevention and control in China.

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“…17 As we previously found, the compliance rate in the 40-49 age group was lower compared with the 50-59 age group. 27 Therefore, the actual risk of intestinal neoplasia in adults aged 45-49 may be higher. 28 Apart from the advantages of establishing the screening age under 50 years for timely detection and prevention of CRC among adults in this age range, 29 it may also contribute to reducing the incidence of CRC and incidence-based mortality in the 50-54 age group.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors of colorectal neoplasia in individuals aged 40–49 years: Findings from screening program in China

Zhang,

Zhang

et al. 2024

J of Gastro and Hepatol

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Background and AimThe incidence of colorectal cancer (CRC) in individuals under 50 is increasing worldwide. We conducted an analysis of colonoscopy findings in high‐risk individuals under 50 in the CRC screening program in Tianjin, China, to determine the detection rate and risk factors of advanced adenomas (AA), advanced colorectal neoplasia (ACN), colorectal neoplasia (CN).MethodsOur study investigated individuals aged 40–49 who underwent CRC screening and completed colonoscopy, 2012–2020, while the 50–54 age group served as a control. We compared the detection rates of AA, ACN, and CN among three age groups using univariate and multivariable logistic regression analyses, and investigated the risk factors associated with AA, ACN, and CN among individuals aged 40–49.ResultsWe found a gradual increase in the detection rate of AA, ACN, and CN among individuals aged 40–54. The detection rates for AA (OR 0.58; 95% CI 0.41–0.81), ACN (OR 0.58; 95% CI 0.43–0.77), and CN (OR 0.64; 95% CI 0.56–0.74) were lower in individuals aged 40–44 compared to 45–49. The detection rates of AA (OR 1.08; 95% CI 0.87–1.34) and ACN (OR 1.12; 95% CI 0.93–1.35) in individuals aged 45–49 were comparable with 50–54. Besides, lifestyle factors, BMI, and FIT are not associated with the detection rates of AA, ACN, and CN among individuals aged 40–49.ConclusionsOur study reveals screening data in individuals under 50, indicating comparable detection rates of AA and ACN in individuals aged 45–49 and 50–54. These findings provide valuable data support for optimizing the optimal age to initiate screening.

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Colorectal Cancer Screening With High Risk-Factor Questionnaire and Fecal Immunochemical Tests Among 5, 947, 986 Asymptomatic Population: A Population-Based Study

Cited by 12 publications

References 45 publications

Colonoscopy surveillance in Lynch syndrome is burdensome and frequently delayed

Colonoscopy surveillance in Lynch syndrome is burdensome and frequently delayed

Modifiable lifestyle factors have a larger contribution to colorectal neoplasms than family history

Prevalence and risk factors of colorectal neoplasia in individuals aged 40–49 years: Findings from screening program in China

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