Chen H D, Li N, Ren J S, Shi J F, Zhang Y M, Zou S M, Zheng Z X, Zhang K, Dai M
Program Office for Cancer Screening in Urban China, Cancer National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2018 Mar 6;52(3):231-237. doi: 10.3760/cma.j.issn.0253-9624.2018.03.004.
To evaluate the compliance rate of screening colonoscopy and associated factors in high-risk populations of colorectal cancer (CRC) in urban China. CRC screening data from the Program of Cancer Screening in Urban China conducted in 12 provinces in 2012-2014 was used in the present study. All 97 445 participants were asked to take epidemiological questionnaire survey to evaluate their cancer risk. Participants who were evaluated as "high risk for CRC" were recommended to receive colonoscopy at designated hospitals. Chi-square tests were used to compare the differences of participation rates between groups. Multivariate logistic regression models were applied to explore the potential factors associated withthe compliance rate of screening colonoscopy. Overall, 97 445 participants of CRC high-risk were included in this analysis, and 14 949 of them took screening colonoscopy, yielding a participation rate of 15.3%. The participation rate varied greatly across provinces, ranging from 25.2% (2 785/11 071) in Heilongjiang to 9.7% (1 698/17 515) in Liaoning. Moreover, the participation rate in 2013-2014 was significantly higher than that in 2012-2013 (17.1%(9 766/57 280) vs 12.9% (5 183/40 165), χ(2)=57.67, 0.001) . The multivariate logistic regression analyses showed that: compared with individuals of 40-49 years old, individuals of 50-59 or 60-69 years old were more willing to accept screening colonoscopy, with of 1.17 (95 1.12-1.22) and 1.13 (95 1.08-1.19), respectively; compared with uneducated individuals, individuals with good educational background of equivalent to high school or higher (1.29, 951.10-1.50) were more willing to accept screening colonoscopy; compared with individuals who never took fecal occult blood tests (FOBT) before, individuals with previous positive FOBT results (1.40, 951.31-1.50) were more willing to accept screening colonoscopy; compared with individuals with no inflammatory bowel diseases (IBD), individuals with IBD (1.63, 951.56-1.69) were more willing to accept screening colonoscopy; Compared with individuals without polyp history, individuals having history of previous polyp detection (1.43, 951.37-1.50) were more willing to accept screening colonoscopy; compared to individuals with no family history of CRC, individuals with history of CRC (1.60, 951.53-1.66) were more willing to accept screening colonoscopy. The overall participation rate of screening colonoscopy among high-risk population of CRC in the 12 participating sites was 15.3%. The study findings indicated that age, education level, history of past fecal occult blood test, IBD, history of polyp, family history of CRC were associated with the compliance rate of colonoscopy in this population-based CRC screening program.
评估中国城市结直肠癌（CRC）高危人群中筛查结肠镜检查的依从率及相关因素。本研究使用了2012 - 2014年在中国12个省份开展的中国城市癌症筛查项目中的CRC筛查数据。所有97445名参与者均接受了流行病学问卷调查以评估其癌症风险。被评估为“CRC高危”的参与者被建议在指定医院接受结肠镜检查。采用卡方检验比较各组参与率的差异。应用多因素逻辑回归模型探讨与筛查结肠镜检查依从率相关的潜在因素。总体而言，本分析纳入了97445名CRC高危参与者，其中14949人接受了筛查结肠镜检查，参与率为15.3%。各省的参与率差异很大，从黑龙江的25.2%（2785/11071）到辽宁的9.7%（1698/17515）。此外，2013 - 2014年的参与率显著高于2012 - 2013年（17.1%（9766/57280）对12.9%（5183/40165），χ² = 57.67，P < 0.001）。多因素逻辑回归分析显示：与40 - 49岁的个体相比，50 - 59岁或60 - 69岁的个体更愿意接受筛查结肠镜检查，比值比分别为1.17（95%置信区间1.12 - 1.22）和1.13（95%置信区间1.08 - 1.19）；与未受过教育的个体相比，具有高中及以上良好教育背景的个体（1.29，95%置信区间1.10 - 1.50）更愿意接受筛查结肠镜检查；与之前从未进行过粪便潜血试验（FOBT）的个体相比，之前FOBT结果为阳性的个体（1.40，95%置信区间1.31 - 1.50）更愿意接受筛查结肠镜检查；与无炎症性肠病（IBD）的个体相比，患有IBD的个体（1.63，95%置信区间1.56 - 1.69）更愿意接受筛查结肠镜检查；与无息肉病史的个体相比，有既往息肉检出史的个体（1.43，95%置信区间1.37 - 1.50）更愿意接受筛查结肠镜检查；与无CRC家族史的个体相比，有CRC家族史的个体（1.60，95%置信区间1.53 - 1.66）更愿意接受筛查结肠镜检查。12个参与地区CRC高危人群中筛查结肠镜检查的总体参与率为15.3%。研究结果表明，年龄、教育水平、既往粪便潜血试验史、IBD、息肉病史、CRC家族史与该基于人群的CRC筛查项目中结肠镜检查的依从率相关。
