Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Health Development Strategy and Health Care System Research, China National Health Development Research Centre, Beijing, China.
Int J Cancer. 2024 Aug 1;155(3):558-568. doi: 10.1002/ijc.34938. Epub 2024 Mar 30.
In populations in China, colorectal cancer (CRC) screening can be mainly accessed through organized screening, opportunistic screening, and physical examination. This screening intervention is found to be effective but the exact coverage rate is difficult to measure. Based on data from published articles, official websites, and available program reports, the screening coverage rate and related indicators were quantified. A rapid review was then conducted to estimate the overall and the breakdown coverage rates of the sub-type screening services, by leveraging the numbers of articles and the by-type median sample sizes. Up to 2020, two central government-funded and four provincial/municipal-level organized CRC screening programs have been initiated and included in this analysis. For populations aged 40-74, the estimated coverage rate of organized programs in China was 2.7% in 2020, and the 2-year cumulative coverage rate in 2019-2020 was 5.3% and the 3-year cumulative coverage rate in 2018-2020 was 7.7%. The corresponding coverage rates of 50-74-year-olds were estimated to be 3.4%, 7.1%, and 10.3%, respectively. Based on the rapid review approach, the overall screening coverage rate for 40-74 years, considering organized screening programs, opportunistic screening, and physical examinations, was then estimated to be 3.0% in China in 2020. However, comparing the findings of this study with the number of health check-ups reported in the local national health statistics yearbooks suggests that the number of CRC physical examinations may be underestimated in this study. The findings suggest that further efforts are needed to improve population access to CRC screening in China. Furthermore, evidence for access to opportunistic CRC screening and physical examination is limited, and more quantitative investigation is needed.
在中国人群中，结直肠癌（CRC）筛查主要可通过有组织筛查、机会性筛查和体检进行。该筛查干预措施被证实是有效的，但确切的覆盖率难以衡量。基于已发表文章、官方网站和现有计划报告中的数据，对筛查覆盖率和相关指标进行了量化。然后，通过利用文章数量和按类型的中位数样本量，进行快速综述以估计亚型筛查服务的总体和细分覆盖率。截至 2020 年，已经启动了两项中央政府资助的和四项省级/市级有组织 CRC 筛查计划，并将其纳入了本分析。对于 40-74 岁人群，2020 年中国有组织计划的估计覆盖率为 2.7%，2019-2020 年的两年累计覆盖率为 5.3%，2018-2020 年的三年累计覆盖率为 7.7%。相应的 50-74 岁人群的覆盖率估计分别为 3.4%、7.1%和 10.3%。基于快速综述方法，考虑到有组织筛查计划、机会性筛查和体检，2020 年中国 40-74 岁人群的总体筛查覆盖率估计为 3.0%。然而，将本研究的发现与当地国家卫生统计年鉴中报告的健康检查数量进行比较表明，本研究中 CRC 体检数量可能被低估。这些发现表明，需要进一步努力提高中国人群获得 CRC 筛查的机会。此外，获得机会性 CRC 筛查和体检的证据有限，需要进行更多的定量调查。
