Cluster Randomization Trial of Sequence Mass Screening for Colorectal Cancer

Zheng, Shu; Chen, Kun; Liu, Xiyong; Ma, Xiaoxin; Yu, Hai; Chen, Kang; Yao, Ke; Zhou, Lun; Wang, Linbo; Qiu, Peiling; Deng, Yongchuan; Zhang, Suzhan

doi:10.1007/s10350-004-6496-2

Cited by 69 publications

(55 citation statements)

References 12 publications

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“…However because of its potential harm, acceptability [13] , availability, and expense [14] , the use of colonoscopy as a one-step screening method for the whole targeted population is unpractical in China. The use of noninvasive screening tests in primary screening, such as iFOBT and questionnaire investigation, have been adopted as the large scale population screening program in China [15] . The iFOBT and questionnaire investigation focused on different aspects.…”

Section: Discussionmentioning

confidence: 99%

Performance value of high risk factors in colorectal cancerscreening in China

Meng¹,

Cai²,

Zhou³

et al. 2009

WJG

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AIM:To analyze the performance value of high risk factors in population-based colorectal cancer (CRC) screening in China. METHODS:We compared the performance value of the immunochemical fecal occult blood test (iFOBT) and other high risk factors questionnaire in a population sample of 13 214 community residents who completed both the iFOBT and questionnaire investigation. Patients with either a positive iFOBT and/or questionnaire were regarded as a high risk population and those eligible were asked to undergo colonoscopy. RESULTS:The iFOBT had the highest positive predictive value and negative predictive value in screening for advanced neoplasia. The iFOBT had the highest sensitivity, lowest number of extra false positive results associated with the detection of one extra abnormality for screening advanced neoplasias and adenomas. A history of chronic cholecystitis or cholecystectomy, chronic appendicitis or appendectomy, and chronic diarrhea also had a higher sensitivity than a history of adenomatous polyps in screening for advanced neoplasias and adenomas. The sensitivity of a history of chronic cholecystitis or cholecystectomy was highest among the 10 high risk factors in screening for nonadenomatous polyps. A history of chronic appendicitis or appendectomy, chronic constipation, chronic diarrhea, mucous and bloody stool, CRC in first degree relatives, malignant tumor and a positive iFOBT also had higher sensitivities than a history of adenomas polyps in screening for non-adenomatous polyps. Except for a history of malignant tumor in screening for non-adenomatous polyps, the gain in sensitivity was associated with an increase in extra false positive results associated with the detection of one extra abnormality. CONCLUSION:The iFOBT may be the best marker for screening for advanced neoplasias and adenomas. Some unique high risk factors may play an important role in CRC screening in China.

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Section: Discussionmentioning

confidence: 99%

Performance value of high risk factors in colorectal cancerscreening in China

Meng¹,

Cai²,

Zhou³

et al. 2009

WJG

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“…However, the sample size is limited by the low colorectal cancer screening rate in the general population. Five randomized intervention studies demonstrated t h a t s c r e e n i n g c o u l d r e d u c e c o l o r e c t a l c a n c e r mortality [3][4][5][6][7] . However, screening rates in the general population are low.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence and mortality of colorectal cancer is increasing rapidly in developing countries [1,2] . Recently, strong evidence from several randomized intervention studies indicated that colorectal cancer screening is effective in reducing its mortality [3][4][5][6][7] . However, the reported compliance of colorectal cancer screening in the general population varies widely and is generally low.…”

Section: Introductionmentioning

confidence: 99%

Barriers to colorectal cancer screening: A case-control study

Cai¹,

Zhang²,

Zhu³

et al. 2009

WJG

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AIM:To investigate barriers to colorectal cancer (CRC) screening in a community population. METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire. Cases were selected from those completing both a fecal occult blood test (FOBT) case and colonoscopy in a CRC screening program in 2004. Control groups were matched by gender, age group and community. Control 1 included those having a positive FOBT but refusing a colonoscopy. Control 2 included those who refused both an FOBT and colonoscopy. RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender. P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2. Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate. Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test. Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid. Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy. CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.

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“…In China, CRC is the fifth-leading cause of cancer mortality, with age-adjusted mortality rates of 5.29 and 3.86 per 100,000 for males and females, respectively (Zheng et al, 2003). Currently, the primary cause of CRC death relates to the development of distant metastases to organs, particularly to liver.…”

Section: Introductionmentioning

confidence: 99%