Low hospital referral rates of school scoliosis screening positives in an urban district of mainland China

Abstract

Significant prevalence rates of adolescent scoliosis in China were suggested in previous studies. However, school screenings for adolescent scoliosis have been suspended due to low rates of positive detection under the past screening system in China. The present study was undertaken to screen for adolescent scoliosis in middle school students under a modern assessment system in a district of Shanghai. We performed a population-based, cross-sectional study of a middle school scoliosis screening program in the Jingan district. In 2015, schoolchildren were initially screened by visual inspection of clinical signs and the forward-bending test. Suspected cases were referred for radiography in hospital for scoliosis diagnosis. A total of 5327 middle school students (grades 6–8) were screened with 520 (9.76%) positives (the positive rates of girls and boys at 15.28% and 4.59%, respectively) and no statistically significant difference among grades. Only 301 positives (57.9%) followed the referral for hospital radiography. There were 102 cases (33.9%) that were diagnosed with scoliosis by radiography criteria (Cobb angle ≥10°) including mild scoliosis (Cobb 10–25) for 94 cases and moderate scoliosis (Cobb 25–40) for 8 cases, and false-positives (Cobb 0) for 39 cases. The putative prevalence rate was estimated as 1.9% from the referred students. Under an accurate and modern assessment system, school screenings can detect scoliosis at a significant rate, but awareness of scoliosis risks is needed for residents in China to take up referrals for hospital diagnosis after school screenings.

Regularities in Diseases of the Musculoskeletal System Developing in Schoolchildren Under Complex Exposure to Environmental Factors and Factors Related to Lifestyle

“…The assessment revealed that diseases of the musculoskeletal system and connective tissue constantly held the 1 st rank place in the structure of morbidity among 4 th grade children as well as middle and senior school children. These results are in line with data provided by foreign and domestic researchers [2,3,[16][17][18][19][20][21].…”

Epidemiological and Diagnostic Characteristics of Scoliosis in Children in a Single Tertiary Centre in Abidjan

“…School screening policies began in the 1960s in the USA. [ 10 14 21 ] Later, some countries such as Japan, Hong Kong or South Africa made it compulsory in their school health policy,[ 5 14 22 ] which enabled them to know the prevalence of IS but also analyse the cost related to screening. [ 1 ] However, the different prevalence reported in the literature must be interpreted with caution because the definition of scoliosis and the study populations are not uniform.…”

The prevalence of posture pathology in school-aged children (results of a population-based study with the use of the computerized photo-geometric program “Posture”)

“…When comparing the data of modern foreign literature [12,13,20,23], the incidence indicators of scoliosis (72.5 %) and postural disorder (75.0 %) in school-aged children coincided.…”

“…Among 79 122 schoolchildren in the city of Wuxi, eastern China, adolescent idiopathic scoliosis was found in 2.4 %, and in the Shanghai area, among 5327 investigated secondary school students (grades 6-8), scoliosis was diagnosed by screening method in 520 children (9.76 %) and spinal X-ray was performed in 102 of them (33.9 %) [12,13].…”