Department of Health Medicine, The Second Medical Center and National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Health Examination Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2023 Jan 20;136(2):159-166. doi: 10.1097/CM9.0000000000002435.
Colorectal cancer (CRC) screening is effective in reducing CRC incidence and mortality. The aim of this study was to retrospectively determine and compare the detection rate of adenomas, advanced adenomas (AAs) and CRCs, and the number needed to screen (NNS) of individuals in an average-risk Chinese population of different ages and genders.
This was a retrospective study performed at the Institute of Health Management, Chinese People's Liberation Army General Hospital. Colonoscopy results were analyzed for 53,152 individuals finally enrolled from January 2013 to December 2019. The detection rate of adenomas, AAs, or CRCs was computed and the characteristics between men and women were compared using chi-squared test.
The average age was 48.8 years (standard deviation [SD], 8.5 years) for men and 50.0 years (SD, 9.0 years) for women, and the gender rate was 66.27% (35,226) vs . 33.73% (17,926). The detection rates of adenomas, AAs, serrated adenomas, and CRCs were 14.58% (7750), 3.09% (1641), 1.23% (653), and 0.59% (313), respectively. Men were statistically significantly associated with higher detection rates than women in adenomas (17.20% [6058/35,226], 95% confidence interval [CI] 16.74-17.53% vs . 9.44% [1692/17,926], 95% CI 8.94-9.79%, P < 0.001), AAs (3.72% [1309], 95% CI 3.47-3.87% vs . 1.85% [332], 95% CI 1.61-2.00%, P < 0.001), and serrated adenomas (1.56% [548], 95% CI 1.43-1.69% vs . 0.59% [105], 95% CI 0.47-0.70%, P < 0.001). The detection rate of AAs in individuals aged 45 to 49 years was 3.17% (270/8510, 95% CI 2.80-3.55%) in men and 1.69% (69/4091, 95% CI 1.12-1.86%) in women, and their NNS was 31.55 (95% CI 28.17-35.71) in men and 67.11 (95% CI 53.76-89.29) in women. The NNS for AAs in men aged 45 to 49 years was close to that in women aged 65 to 69 years (29.07 [95% CI 21.05-46.73]).
The detection rates of adenomas, AAs, and serrated adenomas are high in the asymptomatic population undergoing a physical examination and are associated with gender and age. Our findings will provide important references for effective population-based CRC screening strategies in the future.
结直肠癌（CRC）筛查可有效降低 CRC 的发病率和死亡率。本研究旨在回顾性确定和比较不同年龄和性别的普通风险中国人群中腺瘤、高级别腺瘤（AA）和 CRC 的检出率以及需要筛查的人数（NNS）。
这是一项在解放军总医院健康管理研究所进行的回顾性研究。分析了 2013 年 1 月至 2019 年 12 月期间最终纳入的 53152 名个体的结肠镜检查结果。计算了腺瘤、AA 或 CRC 的检出率，并使用卡方检验比较了男性和女性之间的特征。
男性的平均年龄为 48.8 岁（标准差[SD]，8.5 岁），女性为 50.0 岁（SD，9.0 岁），性别比例为 66.27%（35226）比 33.73%（17926）。腺瘤、AA、锯齿状腺瘤和 CRC 的检出率分别为 14.58%（7750）、3.09%（1641）、1.23%（653）和 0.59%（313）。男性与女性相比，腺瘤（17.20%[6058/35226]，95%置信区间[CI] 16.74-17.53%比 9.44%[1692/17926]，95%CI 8.94-9.79%，P<0.001）、AA（3.72%[1309]，95%CI 3.47-3.87%比 1.85%[332]，95%CI 1.61-2.00%，P<0.001）和锯齿状腺瘤（1.56%[548]，95%CI 1.43-1.69%比 0.59%[105]，95%CI 0.47-0.70%，P<0.001）的检出率均较高。45-49 岁人群中，男性 AA 的检出率为 3.17%（270/8510，95%CI 2.80-3.55%），女性为 1.69%（69/4091，95%CI 1.12-1.86%），NNS 分别为 31.55（95%CI 28.17-35.71）和 67.11（95%CI 53.76-89.29）。45-49 岁男性的 AA 的 NNS 接近 65-69 岁女性（29.07[95%CI 21.05-46.73]）。
无症状体检人群中腺瘤、AA 和锯齿状腺瘤的检出率较高，与性别和年龄有关。我们的研究结果将为未来有效的基于人群的 CRC 筛查策略提供重要参考。
