Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population

Abstract

The performance of combining fecal immunochemical tests (FITs) and a high-risk factor questionnaire (HRFQ) in colorectal cancer (CRC) screening in economically and medically underserved populations is uncertain. This study investigated the performance of a CRC screening protocol of combining FITs and an HRFQ as primary screening methods in a rural Chinese population. A CRC mass screening was conducted using FITs and an HRFQ as the first and colonoscopy as the second stage of screening in Jiashan, [2007][2008][2009]. The target population was 31,963 residents in three communities. The compliance was 84.7% for HRFQ, 76.4% for FITs, and 78.7% for colonoscopy. The detected rates of cancer, adenoma, nonadenomatous polyps, and advanced neoplasm were 2.7%, 14.8%, 5.9%, and 8.9% by FITs, which were higher than those by HRFQ (0.5%, 9.2%, 4.8%, and 3.8%, respectively). There was no significant difference in detected rate for nonadenomatous polyps between FITs and HRFQ. A total of 41.2% adenomas, 53.2% nonadenomatous polyps, and 29.8% advanced neoplasms were detected by HRFQ but missed by FITs. Positive predictive value of the screening protocol of combining FITs and HRFQ for advanced neoplasm was 5.7%, which was higher than FITs alone. Men had a higher prevalence of advanced neoplasm than women. Results indicate that combining FITs and HRFQ as primary screening methods is an efficient CRC screening strategy in economically and medically underserved populations.

Cost-Effectiveness between Double and Single Fecal Immunochemical Test(s) in a Mass Colorectal Cancer Screening

“…A total of 24,419 study participants signed the written informed consent and participated in this CRC screening program. Basic characteristics of the study participants and positive predictive value of this screening have been reported by Cai et al [ 22 ].…”

Comparison of Uptake of Colorectal Cancer Screening Based on Fecal Immunochemical Testing (FIT) in Males and Females: A Systematic Review and Meta-analysis

“…Following review, 19 studies were eligible for inclusion in the review and meta-analysis (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). A flow chart of the search strategy results is provided in Fig.…”

Serum M2-pyruvate kinase: A promising non-invasive biomarker for colorectal cancer mass screening

“…The combined HRFQ has improved compliance rate and screening net sensitivity due to the simultaneous screening design and the overall effectiveness of our screening program. However, the overall false positive rate is high, as is the case in all CRC mass screening programs worldwide [8][9][10][11] . In our CRC mass screening program, 73.3% (false positive rate from iFOBT or HRFQ) of high risk populations previously underwent unnecessary colonoscopy examinations [6,8] .…”