Discussion On The New Model Of Colorectal Cancer Screening In Rural Population Relying On Medical Complex

Objective: This study relies on the close medical complex platform formed by Changsha No.4 Hospital and Yupingping Town Health Center to screen colorectal cancer in rural population over 65 years old in Yupingping Town,Yuelu District,Changsha City,to explore and improve related populations.The method of knowledge of colorectal cancer and the compliance of colonoscopy ultimately improve the early diagnosis and treatment rate of colorectal cancer in rural residents.Methods:This study adopted a retrospective and prospective cohort study design.The subjects were the rural residents over 65 years old in Yuelu District,Ningxiang County,Changsha City,who met the inclusion and exclusion criteria.A self-made questionnaire was used to conduct face-to-face survey of patients who met the criteria.The questionnaire was derived from the questionnaire of Cognition and Compliance of Screening for Colorectal Cancer,which was tested by reliability and validity.It was sinicized on the basis of extensive literature search.The survey included general information of patients,knowledge of cancer and screening,past history of colonoscopy,self-judgement of obstacles to colonoscopy screening proposed in the literature,and completion of fecal occult blood test relying on the free medical examination policy of public health of Yuguangping Plain Health Hospital.Statistical descriptions were made by percentage,binary variable analysis by X2 test,and multivariate analysis by logistic regression model to explore the influencing factors of residents' awareness of colorectal cancer and screening compliance.Results:(1)972 rural residents over 65 years old in Yuelu District,Ningxiang County,Changsha City were studied.A total of 760 complete survey data were obtained,including 340 males and 420 females,with an average age of(69.8 + 4.99)years.The number of female respondents was slightly more than that of male respondents.The female respondents accounted for 55.3% of the total number of respondents,and the male respondents accounted for 44.7% of the total number of respondents.(2)In this valid questionnaire,68 residents were positive in high-risk factors questionnaire,with a positive rate of 8.9%.278 patients completed fecal occult blood test and 33 patients were positive in fecal occult blood,with a positive rate of 12%.The awareness and recognition of colon cancer screening in men wereslightly higher than that in women(3).The results of multivariate logistic regression analysis showed that education was the main risk factor affecting the cognitive level of patients(95% CI: 1.462-3.961,2.182-6.188,P < 0.001).(4)Univariate analysis of colonoscopy screening in high risk factors questionnaire positive and/or fecal occult blood positive population showed that age,educational background,family monthly income,family history of colorectal cancer and history of colonic polyps were risk factors affecting patient compliance.(5)those with high secondary and higher education levels(OR = 1.29,95% CI: 1.10-1.50)were more likely to undergo colonoscopy than those with only elementary education level(OR = 1.29,95% CI:1.10-1.50).The higher the monthly household income of the population sample,the stronger the compliance of enteroscopy screening.Conclusion:(1)The awareness rate and compliance of colorectal cancer screening among rural residents in Changping Town are not high,and the health awareness of rural residents is low.(2)Among the influencing factors of colonoscopy compliance,the relevant cognitive level,educational level,age and economic basis of rural population are the most important factors,and the low level of knowledge is the strongest predictor of colonoscopy compliance.(3)It is very important to strengthen the cognitive education related to colorectal cancer screening in order to improve the acceptance rate of enteroscopy.Efforts to reduce the cost of colonoscopy or to conduct free colonoscopy may help to enhance colonoscopy screening.Make full use of community resources,carry out colorectal cancer education and screening popularization work to provide the basis for improving colorectal cancer screening opportunities.