Xu An-gao, Yu Zhi-jin, Zhong Xu-hui, Gan Ai-hua, Liu Ji-hong, Luo Qiu-yun
Department of Gastroenterology, Huizhou Municipal Central Hospital, Huizhou Institute of Medicine, Guangdong Province, Huizhou 516001, China.
Zhonghua Yi Xue Za Zhi. 2010 Jan 12;90(2):116-8.
To measure the rate of high-risk group and the detection rate of colorectal cancer (CRC) in communities in Guangdong province and to provide scientific rationales for formulating mass screening plans in high-risk group.
Mass survey was conducted by questionnaire combined fecal occult blood test (FOBT) in Huizhou region, Guangdong Province, to sort out the high-risk population of CRC. Then the high-risk population was screened by colonoscopy and pathology to identify CRC. The differences were compared by direct expenditure which was used to calculate screening cost.
A total of 68,953 people were surveyed. There were 940 people in high-risk group (detection rate: 1.36%), 3118 in immunity FOBT positive group (detection rate: 4.52%), Merging aforementioned two groups, there were 3870 in population at risk (detection rate: 5.61%). The CRC detection rate in high-risk group, immunity FOBT positive group, population at risk and average-risk group was 506.3/10(5), 314.3/10(5), 315.9/10(5) and 17.7/10(5) respectively. The positive predictive value of CRC screening scheme by high-risk group questionnaire-colonoscopy was 0.43% while CRC screening scheme by FOBT-colonoscopy 0.22%. In terms of direct expenditure of CRC per case in high-risk group and immunity FOBT positive group was 47,834.5 yuan and 82,303.6 yuan. The latter was 1.7 times than that of the former.
The scheme of questionnaire combined FOBT for CRC is an effective way in mass survey. The scheme by high-risk group questionnaire-colonoscopy has a much better cost-effectiveness than that of the scheme by FOBT-colonoscopy so that it should be one of the preferred methods for individual screening in high-risk group.
测算广东省社区人群中结直肠癌（CRC）高危人群比例及结直肠癌检出率，为制定高危人群大规模筛查方案提供科学依据。
在广东省惠州市地区采用问卷调查结合粪便潜血试验（FOBT）进行大规模调查，梳理出CRC高危人群。然后对高危人群进行结肠镜检查及病理检查以确诊CRC。通过计算直接费用比较差异，以计算筛查成本。
共调查68953人。高危人群940人（检出率：1.36%），免疫FOBT阳性人群3118人（检出率：4.52%），将上述两组合并，高危人群共3870人（检出率：5.61%）。高危人群、免疫FOBT阳性人群、高危人群及平均风险人群中CRC检出率分别为506.3/10万、314.3/10万、315.9/10万和17.7/10万。高危人群问卷调查 - 结肠镜检查CRC筛查方案的阳性预测值为0.43%，而FOBT - 结肠镜检查CRC筛查方案的阳性预测值为0.22%。高危人群和免疫FOBT阳性人群中每例CRC的直接费用分别为47834.5元和82303.6元。后者是前者的1.7倍。
问卷结合FOBT筛查CRC的方案是大规模调查的有效方法。高危人群问卷调查 - 结肠镜检查方案的成本效益远优于FOBT - 结肠镜检查方案，应成为高危人群个体筛查的首选方法之一。
