Analysis Of Baseline Screening Results Of Colorectal Cancer Among Urban Residents In Kunming,Yunnan Province From 2018 To 2019

Objective:To evaluate the participation rate of colonoscopy,fecal immunochemical test(FIT)and individualized screening for colorectal cancer(CRC)screening among urban residents in Kunming,Yunnan Province And the screening effect.Methods:Using a randomized controlled trial study design,from May 2018 to May 2019,population recruitment was carried out in the physical examination center of Wuhua District,Xishan District in Kunming,and Yunnan Cancer Hospital,and subjects who met the inclusion and exclusion criteria were recruited according to 1:2:2 Randomly assigned to three screening groups:colonoscopy group,FIT group(FIT positive patients receive colonoscopy),individualized screening program group(Asia-Pacific Colorectal Screening risk assessment is high-risk population receiving colonoscopy,low-risk population receiving FIT testing,such as FIT positive patients undergoing colonoscopy).The χ2 test and Bonferroni method were used to compare and analyze the screening participation rate,the completion rate of colonoscopy and the detection results of lesions under the colonoscopy in the colonoscopy group,the FIT group and the individualized screening program group.In the three screening groups,which detection results of CRC and advanced adenoma were analyzed by the Bonferroni method based on intention analysis and protocol analysis.Results:1.A total of 2039 people were recruited for baseline screening,and 19 people were excluded from incomplete information entry.A total of 2020 people were included in the analysis,including 755 males and 1265 females;the first group(colonoscopy group,N=415,completed colonoscopy 138 people);Group 2(FIT group,N=828,774 people who completed FIT test,127 people were positive,647 people were negative,FIT positive rate was 16.6%,79 people who completed colonoscopy);Group 3(individualized in the screening program group,N=777 people,a total of 657 people completed.Among them,high-risk:125 people,49 people completed colonoscopy;low-risk:652 people,FIT positive 71 people,negative 537 people,FIT positive rate was 10.9%,46 people completed colonoscopy).2.Among the three screening groups,the FIT group and the individualized screening program group had a higher participation rate than the colonoscopy group(87.7%vs.81.3%vs.33.3%).The completion rate of colonoscopy in the FIT group and the individualized screening program group was higher than that in the colonoscopy group,with the FIT group having the highest completion rate(62.2%vs.48.5%vs.33.3%,P<0.017).In the individualized screening program group,the analysis was divided into two subgroups and found that the colonoscopy completion rate of the high-risk group was 39.2%,and the colonoscopy completion rate of the low-risk group was 64.8%.3.Among the three screening groups,a total of 311 people were completed colonoscopy,106 of whom had colorectal lesions,of which 2 were detected by CRC,53 were detected by advanced adenoma,and 33 were detected by non-advanced adenoma,other polyposis or inflammation were detected in 18 cases,the detection rate of lesions was 34.1%;The detection rate of lesions under colonoscopy in the FIT group and the individualized screening program group was higher than that in the colonoscopy group(38.5%vs.38.9%vs.28.3%,P<0.017).4.Using Intention-To-Treat and Per-Protocol principle to analysis the three screening groups,then compared to each other,it was found that for the detection of AA,the FIT group and the individualized screening program group were higher than the colonoscopy group(P<0.017).Conclusions:1.Compared with a single screening mode(colonoscopy),the FIT screening program and individualized screening program can increase the participation rate,compliance,colonoscopy completion rate and detection rate of lesions of CRC screening for urban residents in Kunming,Yunnan Province;2.In terms of the improvement in the completion rate of colonoscopy,the FIT screening program is superior to the individualized screening program;in summary,this study is expected to provide more references for the selection of CRC screening programs for the future population.