| OBJECTIVE To explore the feasibility and specificity of the application of suitable screening technology for colorectal cancer screening in Baiyin area,and to understand the proportion of high-risk groups and the incidence of colorectal cancer initially,to provide practical experience for the prevention and treatment of colorectal cancer in Gansu Province.METHODS Multi-stage stratified sampling for colorectal cancer screening were used to populations who aged 40 to 74 years old in three counties and two districts of Baiyin area,about 50,000 people,from 22(th)February,2016 to 22(th)March,2016.A total of eleven townships and/or sub-district offices were selected.As intial screening methods,one-on-one questionnaire and immunoassay fecal occult blood test were applied to the inhabitants who met the standard.Then,patients whose questionnaire or/and immunoassay fecal occult blood test was positive were the initial screening positive people,the further screening method was electronic colonoscopy if the intial screening result was positive,pathological examination was used as a method to definite diagnosis if necessary.SPSS24.0,Excel 2016,Graph Pad Prism software were applied to process and analysis data.RESULT The total population of Baiyin area is 1,708,800,and the population aged 40 to 74 years old is about 664,400.A total of 50,000 questionnaires were distributed to inhabitants in this study,including 22,000 urban population and 28,000 rural population.38,290 questionnaires were recovered,including 16,578 urban population and 21,712 rural population.The response rate was 76.58%(38290/50000).26,160 valid questionnaires were completed,including 9448 urban population and 16712 rural population,with a total compliance rate of 68.32%(26160/38290),urban population compliance rate was 56.99%(9448/16578),rural was 76.97%(16712/21712).925 questionnaires were positive among all valid questionnaires,accounting for 3.54 %(925/26160).25,189 fecal occult blood tests were completed,including 8822 urban population and 16367 rural population.A total compliance rate of fecal occult blood test was 65.79%(25189/38290),49.6%(8822/16578)of urban population compliance rate and 75.38%(16367/21712)of rural population compliance rate.158 fecal occult blood tests were positive,accounting for 0.63%(158/25189).Of patients with a positive questionnaire,52 fecal occult blood tests were positive,accounting for 5.62%(52/925).Of patients with a positive fecal occult blood test,106 questionnaires were negative,accounting for 67.1%(106/158).There were 1031 high-risk persons(positive questionnaire or positive fecal occult blood test)(925+158-52)in the study,accounting for 3.94%(1031/26160).Of people who were high-risk,43 people decided to make further electron colonoscopy,with a compliance rate of 4.17%(43/1031).6 colorectal cancers were found and the detection rate of colorectal cancer was 14%(6/43),colorectal polyps were detected in 12 cases,27.9%(12/43).A preliminary cost-effectiveness assessment was made to screen colorectal cancer high-risk population.200,000 yuan was spent on scientific research totally,and the average cost per person was about 5.22 yuan.Finding a case of colorectal cancer or colorectal polyps cost about 11,000 yuan.The largest proportion of participants were 40 to 49 years old in the screening areas,accounting for 37.64%(9847/26160).The rate of the positive questionnaire increased with age(χ2=33.39,p<0.05).The positive rate of male questionnaire was 2.9%(373/12707)which is lower than female(4.1%,552/13453).The positive rate of fecal occult blood test increased with age(χ2=20.31,p<0.05).The positive rate of male fecal occult blood test was 0.74%(92/12358)which is higher than female(0.51%)(66/12831).The rate of the positive fecal occult blood test of people whose questionnaire was positive was higher than negative questionnaire population(χ2=402.15,p<0.05).Among high-risk factors,chronic cholecystitis or history of cholecystectomy,chronic constipation,chronic appendicitis or history of appendectomy account for more proportions.Twelve of the patients with colorectal polyps were treated by endoscopic resection.Six patients with colorectal cancer received timely intervention.CONCLUSION 1.The screening population in Baiyin area has weak awareness of colorectal cancer and weak willingness to participate in screening.The compliance of urban population is lower than that in rural areas.The compliance about electronic colonoscopy screening is low as well.It is necessary to increase propaganda and to improve the awareness of colorectal cancer prevention and cure knowledge;2.The Questionnaire survey,immunological fecal occult blood test,electronic colonoscopy can be used as screening methods for colorectal cancer in Gansu Province,which have provided work experience and theoretical basis for further screening of colorectal cancer in Gansu Province;3.The government should increase the input of human and material resources to improve the compliance of colorectal cancer screening. |
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