The Implementation and First-Round Results of a Community-Based Colorectal Cancer Screening Program in Shanghai, China

Abstract

There is good evidence of the benefits of early detection of cancer and removal of adenomas in asymptomatic individuals; however, the widespread implementation of colorectal screening programs is resource‐dependent. Such programs have been widely implemented in high‐income regions and countries in North America, Europe, Japan, and South Korea, but such programs are few in low and middle‐income countries [35]. This article describes the implementation of a comprehensive approach to colorectal cancer screening in Shanghai, China.

Effectiveness of a short message service intervention to motivate people with positive results in preliminary colorectal cancer screening to undergo colonoscopy: A randomized controlled trial

“…Colonoscopy adherence in the population with positive preliminary screening results determines the effectiveness of CRC screening and early diagnosis. However, unsatisfactory levels of colonoscopy adherence have been reported in some studies, and even lower adherence has been reported in China . From 2012 to 2013, data from 14 cities in China showed that among high‐risk urban residents with positive results on preliminary screening with questionnaires, only 33.25% underwent colonoscopy .…”

Important Role of Health Surveillance Systems in Community-Based Colorectal Cancer Screening

“…In this issue of The Oncologist , Gong, Peng, and colleagues from the Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC) report on the planning, implementation, and outcomes of the first round of a community‐based colorectal cancer program in Shanghai, People's Republic of China . The report illustrates the importance of fundamental components of public health surveillance and health service delivery systems needed to support a community‐based screening program.…”

“…Data from the periodic population‐based risk factor surveillance survey were useful to show low reported use of colorectal cancer screening modalities in the general population. The Shanghai government further invested in a dedicated, web‐based colorectal cancer screening registry and information management system , linked to cancer outcomes in the vital and cancer registries via unique personal identifying number. These data resources enable the Shanghai CDC to optimally evaluate the costs, operations, and impact of the screening program in reducing colorectal cancer mortality and morbidity in the defined target population.…”

“…Linkage of various databases using unique personal identifying numbers is needed to monitor and evaluate operation of the screening program and to measure the impact of the screening program in achieving its goals. The information management system dedicated to the cancer screening program enabled listing of the population eligible for screening, tracking of the initial screening using the risk assessment questionnaire and the immunological fecal occult blood test (FIT), tracking of initial screening outcomes, subsequent referrals, and completion of diagnostic testing and treatment, all with reminder systems for program providers and participants.…”

“…The Shanghai report is noteworthy in that it highlights the elements that contributed to the success of the screening program . The health surveillance system enabled the availability and use of local vital and cancer registry data, collected over decades, to make sound public health decisions.…”