| Objective:Colorectal cancer(CRC)is one of the most common and multiple malignancies in the world.The incidence of colorectal cancer has attracted the attention of health departments in many countries,and screening has been carried out for many years.Screening strategies also differ significantly between countries,regions and individual populations.China’s relevant guidance documents suggest that colorectal cancer screening targets are the general population aged 40-74 years old,screening subjects by fecal occult blood testing(FOBT)and High Risk Factors Questionnaire(HRFQ).As high incidence areas of colorectal cancer,it is very necessary to carry out colorectal cancer screening in Gaizhou and Sujiatun of Liaoning Province.Epidemiological method has been adopt to collecte colorectal cancer screening data in gaizhou and Sujiatun since 2016,analysis the basic features of the risk and compare the value of several existing screening program,at the same time explore a better risk evaluation model and provide personalized solutions for colorectal cancer screening.Methods:171,476 permanent residents aged from 40 to 74 in the two regions were included in the screening from 2016 to 2020,of which 66,433 cases finishied screened.Based on the data reported at each screening site,the preliminary screening and diagnostic examination results of the screening subjects were obtained.The results of colonoscopy and pathological examination were used as the final diagnosis,the diagnostic ability of different screening methods was compared,and the sensitivity of each method was analyzed.SPSS 22.0 analysis software was used for statistical analysis to analyze the detection of colorectal cancer literature factors and the incidence of colorectal cancer in the population in this area.According to the results of Logostic regression analysis,statistically significant risk factors were selected to establish a risk assessment model for colorectal cancer screening,so as to provide a diverse selection of colorectal cancer screening programs with local characteristics in the region.Results:66,433 people completed the primary screening for colorectal cancer,with a completion rate of 38.74%.9915 people completed Re-screening,and the inspection proportion was 51.90%.339 patients were pathologically positive,with a diagnosis rate of 3.42%.Preliminary results show that the men in smoking,drinking,tea,meat,fish,vegetables,grains,history of diarrhea and ulcerative colitis are significantly higher than women,women are often drink milk,family history of cancer,and esoteric,appendicitis,cholecystitis,the history of negative life events and the history of cancer are significantly higher than male.Age stratification,various age groups in smoking,drinking,drinking tea,meat,fish,vegetables,grains,history of sports,drink milk appendicitis,negative life events,family history of tumor,mucous bloody stool history of history,history of cancer,diarrhea,and secret history,history of cholecystitis,history of ulcerative colitis,stomach,duodenum ulcer have differences in history,diabetes history.To evaluate different screening methods for colorectal cancer,the combined questionnaire and faecal occult blood survey were found to have higher sensitivity and greater significance for screening.There were statistically significant differences in age,sex,education level,BMI,alcohol consumption,regular exercise or physical labor,history of chronic diarrhea,history of mucus or blood stools,history of adverse life events,and history of intestinal polyps between pathogen-positive and case-negative groups.The risk of colorectal cancer increased with the increase of individual risk factors.Analyzing the number of risk factors for colorectal cancer in the population,it was found that the risk of colorectal cancer increased with the increase of the number of risk factors for colorectal cancer in individuals.Logistic regression analysis indicated that age,history of chronic diarrhea,history of mucus and/or blood stools,history of adverse life events and family history of cancer were risk factors for the incidence of colorectal cancer in this study population.Regular exercise or physical labor and BMI were protective factors.The risk assessment model of colorectal cancer was established,and the risk factors of colorectal cancer and the population base incidence were comprehensively considered.We got Logit(P)=-8.55+0.64x1+0.63x2+0.59x3+0.95x4+0.57x5 to assess the risk of disease among individuals in the area.Conclusion:1.The greater the number of individual risk factors for colorectal cancer,the more likely an individual is to develop colorectal cancer.The combination of risk factor questionnaire and fecal occult blood test can improve the screening efficiency;2.Old age,history of chronic diarrhea,history of mucus and blood stools,history of adverse life events,and family history of cancer were risk factors for colorectal cancer in this population;Gender(female),high education level,regular exercise or physical labor were the protective factors for colorectal cancer in this population.3.Proper use of the colorectal cancer risk assessment model can improve the efficiency of colorectal cancer screening,save money and manpower,and help improve the compliance of screening. |
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