Literature DB >> 32047765

An early report of a screening program for colorectal cancer in Guangzhou, China.

Yujing Fang1, Binyi Xiao1, Jianhong Peng1, Huan Tian2, Fulong Wang1, Lingheng Kong1, Shiyong Lin1, Jibin Li1, Qiying Su2, Kunwu Luo2, Meixian Ye1, Qingjian Ou1, Wenhua Fan1, Cong Li1, Junzhong Lin1, Rongxin Zhang1, Wenhao Zhou1, Liren Li1, Gong Chen1, Zhenhai Lu1, Xiaojun Wu1, Peirong Ding1, Meichun Zheng1, Xia Yang1, Zhizhong Pan1, Desen Wan1.   

Abstract

BACKGROUND: We launched a screening program for colorectal cancer (CRC) in Yuexiu District, Guangzhou, China, in 2014. Here we aimed to report the early results of the program and evaluate the benefits of a screening questionnaire.
METHODS: Residents aged between 50 and 74 were eligible for the screening. A questionnaire and two consecutive fecal immunological tests (FITs) were used as primary screening methods. Subjects who were positive for any of the two tests were referred for further examination with colonoscopy. Neoplasms were removed either colonoscopically or by colectomy. Atypical adenoma and CRC were defined as advanced neoplasms.
RESULTS: A total of 6,971 residents in Dadong Street, Yuexiu District were screened with a questionnaire, and among them, 5,343 underwent at least one FIT. Four thousand and two hundred eleven (60.4%) were female, and 2,760 (39.6%) were male, with a median age of 62.0 years. Questionnaire and FITs identified 1,219 candidates for further examination with colonoscopy, among whom only 647 (53.1%) comply. As of this writing, 623 colonoscopy results were obtained, among which 270 (43.3%) had positive findings. The adenoma detection rate (ADR) was 43.3% (270/623). The ADR was 43.3% (270/623). Of the 270 patients, 10 (3.07%) had CRC, 81 (30.0%) had advanced adenoma, 178 had low-grade adenoma or other benign polyps, one had carcinoid. Except for three advanced CRC, all neoplasms detected were benign or in an early stage.
CONCLUSIONS: Our screening program help identified patients with colonic neoplasms at an early stage, precluding them from developing into the malignant disease. The addition of the questionnaire significantly increased the sensitivity of primary screening, while also decreasing the specificity. Long-term results should evaluate the social and economic benefits of this program. 2019 Annals of Translational Medicine. All rights reserved.

Entities:  

Keywords:  Polyps; colorectal cancer (CRC); early screening; fecal immunological test (FITs)

Year:  2019        PMID: 32047765      PMCID: PMC7011592          DOI: 10.21037/atm.2019.09.75

Source DB:  PubMed          Journal:  Ann Transl Med        ISSN: 2305-5839


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5.  Factors associated with positive predictive value of preliminary screening in a two-step screening strategy for colorectal neoplasms in China.

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