Performance value of high risk factors in colorectal cancerscreening in China

Meng, Wen; Cai, Sanjun; Zhou, Lun; Dong, Qi; Zheng, Shu; Zhang, Suzhan

doi:10.3748/wjg.15.6111

Cited by 51 publications

(89 citation statements)

References 31 publications

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“…FITs (test kits were purchased from W.H.P.M., Inc.) was repeated twice at an interval of 1 week. HRFQ positive means (i) individuals having one of the following events: (a) a history of cancer, (b) a history of polyps, and/or (c) a family history of CRC in first-degree relatives; and/or (ii) at least 2 of the following events: (a) chronic coprostasis, (b) chronic diarrhea, (c) phlegmatically blood feces, (d) serious unhappy life events such as death among first-degree relatives, (e) chronic appendicitis or appendectomy, and/or (f) chronic cholecystitis or cholecystectomy (12,14). If either the FIT or HRFQ was positive, a colonoscopy was recommended in the second stage.…”

Section: Study Design and Populationmentioning

confidence: 99%

“…From 2007, when a national CRC screening program began, the CRC screening protocol based on the previous protocol was revised by the China National Committee of Cancer Early Detection and Treatment (12), aimed at finding more early CRC cases and premalignant lesions such as adenoma. The first pilot field of this national screening program is in Jiashan County, which is recognized as a high-risk CRC county in China.…”

Section: Introductionmentioning

confidence: 99%

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Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population

Cai

Zhang

Zhu

et al. 2011

Cancer Prevention Research

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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, [2007][2008][2009]. 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.

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Section: Study Design and Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population

Cai

Zhang

Zhu

et al. 2011

Cancer Prevention Research

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“…A two-step screening strategy has been recommended for populationbased CRC screening in China: the iFOBT and a quantitative high-risk factor questionnaire as the primary screening test, and a full colonoscopy for follow-up screening. 16 The iFOBT was shown to have higher sensitivity and specificity than the gFOBT, and two-consecutive stool sample testing was more cost-effective for CRC screening. 17 A recent study has validated a scoring system for predicting the risks of colorectal neoplasia based on age, gender, smoking, family history, body mass index (BMI), and diabetes, which may be useful for preliminary CRC screening and requires further investigation.…”

Section: Crc Screening In Chinamentioning

confidence: 99%

Colorectal cancer screening of the general population in East Asia

Sano¹,

Byeon

et al. 2016

Digestive Endoscopy

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In recent years, the incidence of colorectal cancer (CRC) has been increasing, and CRC has been becoming the major cause of cancer deaths in Asian countries. Therefore, an organized screening program to reduce CRC incidence and mortality is currently implemented in each country. In the present review, we summarize the current status and future perspectives of CRC screening of the general population in East Asian and South-East Asian countries. The fecal occult blood test is widely used for CRC screening in these countries, and its effectiveness in reducing CRC incidence and mortality has been demonstrated; however, the low participation rate in CRC screening programs is a problem to be solved in every country. Improvement in the public awareness of CRC and promotion of CRC screening by physicians will help to raise the participation rate and reduce the number of deaths caused by CRC. Regarding screening colonoscopy, several studies have recently demonstrated its effectiveness in reducing CRC incidence and mortality. However, at present, CRC screening colonoscopy is not adopted as a primary population-based screening tool because of staffing constraints in relation to large population sizes, increased medical costs, and potential adverse events (e.g. perforation and drug-induced anaphylaxis). Further study is required to consider colonoscopy as CRC screening that is established in Western countries.

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“…In order to increase the compliance rate, a screening protocol combining iFOBT with a high risk factors questionnaire (HRFQ) approach as the primary test to screen high risk populations, followed by colonoscopy as a follow-up test to detect CRC and other colorectal diseases, has been recommended by the Department of Disease Prevention and Control, the Ministry of Health of China, for CRC mass screening in China, based on the work of Zheng and her team [7] . This protocol has been used in the China national screening program in the general population in recent years [5,6,8] . The combined HRFQ has improved compliance rate and screening net sensitivity due to the simultaneous screening design and the overall effectiveness of our screening program.…”

Section: Introductionmentioning

confidence: 99%

Serum M2-pyruvate kinase: A promising non-invasive biomarker for colorectal cancer mass screening

Meng¹,

Zhu

Xu³

et al. 2012

WJGO

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Author contributions: Meng W and Zhu HH contributed equally to this work; Meng W conducted the study, data collection, management and analysis, and drafted the manuscript; Zhu HH did data correction, designed the analysis strategy and did data interpretation, co-drafted and revised the manuscript, reviewed and edited the whole manuscript; Xu ZF performed quality control on ELISA work; Cai SR performed previous screening work and collection of serum samples; Dong Q performed helpful work in previous screening; Pan QR did part of ELISA work; Zheng S co-supervised the field activities and designed the study's analytical strategy; Zhang SZ co-designed the study, co-supervised the field activities and did quality assurance and control. METHODS:We conducted a molecular epidemiology study in Hangzhou, China, from year 2006 to year 2008. Serum samples were collected from 93 CRC, 41 advanced adenomas, 137 adenomas, 47 non-adenomatous polyps, and 158 normal participants in a community setting. Serum M2-PK and carcinoembryonic antigen (CEA) were measured using Enzyme-linked immunosorbent assay. SPSS 16.0 software was used to perform data analysis. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificities were estimated for serum M2-PK in diagnosis of colorectal lesions and compared with CEA. RESULTS:Average serum M2-PK value among 158 normal people was 2.96 U/mL and not affected by gender (P = 0.47) or age (P = 0.59). Average serum M2-PK (U/mL) was 14.75 among stage Ⅲ and 13.10 among stage Ⅰ and Ⅱ CRC patients, about 4 times higher than that among normal people. Average serum M2-PK was 8.58, 6.70, 5.13 and 2.51 U/mL among advanced adenoma, adenomas, non-adenomatous polyps, and inflammatory bowel disease patients, respectively. AUC for serum M2-PK was greater than that for CEA among all colorectal lesions. AUC for serum M2-PK was 0.89 (0.84, 0.94) (95% confidence interval), higher than that for CEA [0.70 (0.62-0.79 The diagnostic sensitivity for all colorectal lesions increased with decrease in the cut-off value of serum M2-PK. The diagnostic sensitivity (%) of serum M2-PK was 100.00 for CRC, 95.12 advanced adenoma, 82.48 adenoma, and 82.98 non-adenomatous polyp. There were no CRC cases missed and 40.51% of BRIEF ARTICLE

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Performance value of high risk factors in colorectal cancerscreening in China

Cited by 51 publications

References 31 publications

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

Colorectal cancer screening of the general population in East Asia

Serum M2-pyruvate kinase: A promising non-invasive biomarker for colorectal cancer mass screening

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