AIM:To analyze the performance value of high risk factors in population-based colorectal cancer(CRC) screening in China.METHODS:We compared the performance value of the immunochemical fecal occult blood test(iFOBT) an...AIM:To analyze the performance value of high risk factors in population-based colorectal cancer(CRC) screening in China.METHODS:We compared the performance value of the immunochemical fecal occult blood test(iFOBT) and other high risk factors questionnaire in a population sample of 13 214 community residents who completed both the iFOBT and questionnaire investigation.Patients with either a positive iFOBT and/or questionnaire were regarded as a high risk population and those eligible were asked to undergo colonoscopy.RESULTS:The iFOBT had the highest positive predictive value and negative predictive value in screening for advanced neoplasia.The iFOBT had the highest sensitivity,lowest number of extra false positive results associated with the detection of one extra abnormality for screening advanced neoplasias and adenomas.A history of chronic cholecystitis or cholecystectomy,chronic appendicitis or appendectomy,and chronic diarrhea also had a higher sensitivity than a history of adenomatous polyps in screening for advanced neoplasias and adenomas.The sensitivity of a history of chronic cholecystitis or cholecystectomy was highest among the 10 high risk factors in screening for nonadenomatous polyps.A history of chronic appendicitis or appendectomy,chronic constipation,chronic diarrhea,mucous and bloody stool,CRC in first degree relatives,malignant tumor and a positive iFOBT also had higher sensitivities than a history of adenomas polyps in screening for non-adenomatous polyps.Except for a history of malignant tumor in screening for non-adenomatous polyps,the gain in sensitivity was associated with an increase in extra false positive results associated with the detection of one extra abnormality.CONCLUSION:The iFOBT may be the best marker for screening for advanced neoplasias and adenomas.Some unique high risk factors may play an important role in CRC screening in China.展开更多
AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected f...AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in 2004.Control groups were matched by gender, age group and community.Control 1 included those having a positive FOBT but refusing a colonoscopy.Control 2 included those who refused both an FOBT and colonoscopy.RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2.Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate.Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test.Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid.Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy.CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.展开更多
AIM： To increase attendance tor colonoscopy among nonadherent high-risk individuals for colorectal cancer （CRC） screening in China. METHODS： During the first 12 mo without intervention, only 428 of the 2398 high-r...AIM： To increase attendance tor colonoscopy among nonadherent high-risk individuals for colorectal cancer （CRC） screening in China. METHODS： During the first 12 mo without intervention, only 428 of the 2398 high-risk subjects attended a scheduled colonoscopy examination. The 1970 subjects who did not attend for CRC screening were enrolled in the present study. Prior barrier investigation was performed to ascertain the reasons for nonadherence. A barrier-focused intervention program was then established and implemented among eligible nonadherent subjects by telephone interviews and on-site consultations. The completion rates of colonoscopy during the first 12 mo without intervention and the second 12 mo with intervention were compared. Variations in the effect of the intervention on some high-risk factors and barrier characteristics were analyzed using logistic regression. RESULTS： 540 subjects who were not eligible were excluded from the study. The colonoscopy attendance rate was 23.04% （428/1858） during the first 12 mo without intervention, and 37.69% （539/1430） during the second 12 mo with intervention （P 〈 0.001）. Logistic regression analysis showed that the intervention was more effective among subjects with only objective barriers （OR： 34.590, 95% CI： 23.204-51.563） or subjects with some specific highrisk characteristics： first-degree relatives diagnosed with CRC （OR： 1.778, 95% CI： 1.010-3.131）, personal history of intestinal polyps （OR： 3.815, 95% CI： 1.994-7.300） and positive result for immunochemical fecal occult blood testing （OR： 2.718, 95% CI： 1.479-4.996）. CONCLUSION： The barrier-focused telephone or on- site consultation intervention appears to be a feasible means to improve colonoscopy attendance among nonadherent high-risk subjects for CRC screening in China.展开更多
基金Supported by 11th 5-Year Key Programs for Science and Technology Development of China,No.2006BAI02A08
文摘AIM:To analyze the performance value of high risk factors in population-based colorectal cancer(CRC) screening in China.METHODS:We compared the performance value of the immunochemical fecal occult blood test(iFOBT) and other high risk factors questionnaire in a population sample of 13 214 community residents who completed both the iFOBT and questionnaire investigation.Patients with either a positive iFOBT and/or questionnaire were regarded as a high risk population and those eligible were asked to undergo colonoscopy.RESULTS:The iFOBT had the highest positive predictive value and negative predictive value in screening for advanced neoplasia.The iFOBT had the highest sensitivity,lowest number of extra false positive results associated with the detection of one extra abnormality for screening advanced neoplasias and adenomas.A history of chronic cholecystitis or cholecystectomy,chronic appendicitis or appendectomy,and chronic diarrhea also had a higher sensitivity than a history of adenomatous polyps in screening for advanced neoplasias and adenomas.The sensitivity of a history of chronic cholecystitis or cholecystectomy was highest among the 10 high risk factors in screening for nonadenomatous polyps.A history of chronic appendicitis or appendectomy,chronic constipation,chronic diarrhea,mucous and bloody stool,CRC in first degree relatives,malignant tumor and a positive iFOBT also had higher sensitivities than a history of adenomas polyps in screening for non-adenomatous polyps.Except for a history of malignant tumor in screening for non-adenomatous polyps,the gain in sensitivity was associated with an increase in extra false positive results associated with the detection of one extra abnormality.CONCLUSION:The iFOBT may be the best marker for screening for advanced neoplasias and adenomas.Some unique high risk factors may play an important role in CRC screening in China.
基金Supported by The National Scientific and Technological Program in the 11th "Five-Year Plan", the Grant number is 2006BAI02A08
文摘AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in 2004.Control groups were matched by gender, age group and community.Control 1 included those having a positive FOBT but refusing a colonoscopy.Control 2 included those who refused both an FOBT and colonoscopy.RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2.Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate.Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test.Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid.Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy.CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.
基金Supported by 11th 5-year Key Program for Science and Technology Development of China,No.2006BAI02A08
文摘AIM： To increase attendance tor colonoscopy among nonadherent high-risk individuals for colorectal cancer （CRC） screening in China. METHODS： During the first 12 mo without intervention, only 428 of the 2398 high-risk subjects attended a scheduled colonoscopy examination. The 1970 subjects who did not attend for CRC screening were enrolled in the present study. Prior barrier investigation was performed to ascertain the reasons for nonadherence. A barrier-focused intervention program was then established and implemented among eligible nonadherent subjects by telephone interviews and on-site consultations. The completion rates of colonoscopy during the first 12 mo without intervention and the second 12 mo with intervention were compared. Variations in the effect of the intervention on some high-risk factors and barrier characteristics were analyzed using logistic regression. RESULTS： 540 subjects who were not eligible were excluded from the study. The colonoscopy attendance rate was 23.04% （428/1858） during the first 12 mo without intervention, and 37.69% （539/1430） during the second 12 mo with intervention （P 〈 0.001）. Logistic regression analysis showed that the intervention was more effective among subjects with only objective barriers （OR： 34.590, 95% CI： 23.204-51.563） or subjects with some specific highrisk characteristics： first-degree relatives diagnosed with CRC （OR： 1.778, 95% CI： 1.010-3.131）, personal history of intestinal polyps （OR： 3.815, 95% CI： 1.994-7.300） and positive result for immunochemical fecal occult blood testing （OR： 2.718, 95% CI： 1.479-4.996）. CONCLUSION： The barrier-focused telephone or on- site consultation intervention appears to be a feasible means to improve colonoscopy attendance among nonadherent high-risk subjects for CRC screening in China.
