Determinants of Participation and Detection Rate of Colorectal Cancer From a Population-Based Screening Program in China

Abstract

Colorectal cancer (CRC) screening has been widely implemented in Europe and the USA. However, there is little evidence of participation and diagnostic yields in population-based CRC screening in China. The participation rate and detection of colorectal lesions in this program were reported and related factors were explored. The analysis was conducted in the context of the Cancer Screening Program in Urban China, which recruited 282,377 eligible participants aged 40-74 years from eight cities in Henan province from 2013 to 2019. A total of 39,834 participants were evaluated to be high risk for CRC by an established risk score system and were subsequently recommended for colonoscopy. Of 39,834 with high risk for CRC, 7,454 subjects undertook colonoscopy (participation rate of 18.71%). We found that 50-64 years, high level of education, marriage, former smoking, current alcohol drinking, low levels dietary intake of vegetables, high levels dietary intake of processed meat, lack of physical activity, fecal occult blood test positive result, history of colonic polyp, history of colorectitis, and family history of CRC were associated with increased participation of colonoscopy screening. Overall, 17 CRC (0.23%), 95 advanced adenoma (1.27%), 478 non-advanced adenomas dysplasia (6.41%), 248 hyperplastic polyp (3.33%), and 910 other benign lesions (12.21%) were detected. The findings from the study will provide important references for designing effective population-based CRC screening strategies in the future. Given the relatively low participation rate, there was room for improvement in the yield of CRC screening.

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

“…Thus, another aim of this study was to assess the examination rate and diagnostic utility of colonoscopy in different screening methods in the Tianjin CRC screening program. We observed that the compliance rate of colonoscopy among the high-risk group in our study was 22.23%, which was higher than that observed in other studies (range, 14.0%-18.7%) ( 21 , 31 , 32 ). Of these, the compliance rate for colonoscopy among positive FIT participants was 33.84%; lower than that observed in a prior study (78.4%) ( 33 ), while the compliance rate for colonoscopy among positive HRFQ participants was 16.96%.…”

Assessment of Modifiable Factors for the Association of Marital Status With Cancer-Specific Survival

“…7 Published data indicate increased utilization of colorectal, prostate, and breast cancer screenings by married individuals. [28][29][30] Based on our findings, specific interventions for unmarried individuals should be developed to facilitate their access to primary care and increase their screening rates for breast, colorectal, and endometrial cancers, which may render earlier diagnoses and reduce CSS disparities between married and unmarried populations.…”

Colorectal Cancer: A Systematic Review of the Current Situation and Screening in North and Central Asian Countries

“…CRC detection rate is 0.05% for screening in Kazakhstan and 0.2% for screening in Lithuania. These numbers are comparable to screening in HIC and other LMIC with CRC detection rates varying from 0.1 to 0.4% [52,53]. Additional risk factors prevalent in the region increasing the CRC trend includes male liquidators from the Gomel region in Belarus and petrol plant workers in Russia wherein the CRC detection rate was 0.45% [32,49].…”