Current status of participation rate in population-based colorectal cancer screening programs in China and its associated factors_West China Medical Journal

Authors：

CHEN Hongda , LU Ming ,  DAI Min

National Cancer Center / National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P. R. China;

Corresponding?author：

DAI Min, Email: daimin2002@hotmail.com

Keywords：

Colorectal cancer; Screening; Adherence; Participation rate

DOI：

10.7507/1002-0179.201812094

Video：

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Colorectal cancer (CRC) screening is effective in reducing the burden of the disease. Participation rate is an important determinant of the magnitude of the effectiveness in population-based CRC screening. We summarize the current status of participation rate across the different organized CRC screening programs in China. The results indicate that the overall participation rates are low, and the acceptance of the screening protocols is poor in Chinese population. We conclude that the associated factors may include the poor health consciousness, low willingness-to-pay for screening, lack of personalized screening strategy and inadequate organization. Studies on the inventions to improve the willingness of screening and participation rate are of high demand and will provide important references in implementing large-scale CRC screening programs in China in the future.

Citation： CHEN Hongda, LU Ming, DAI Min. Current status of participation rate in population-based colorectal cancer screening programs in China and its associated factors. West China Medical Journal, 2018, 33(12): 1455-1459. doi: 10.7507/1002-0179.201812094 Copy

1.	Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018, 30(1): 1-12.
2.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3.	Wolf AMD, Fontham ETH, Church TR, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin, 2018, 68(4): 250-281.
4.	Zorzi M, Fedeli U, Schievano E, et al. Impact on colorectal cancer mortality of screening programmes based on the faecal immunochemical test. Gut, 2015, 64(5): 784-790.
5.	Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ, 2014, 348: g2467.
6.	Lew JB, St John DJB, Xu XM,et al. Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: a modelling study. Lancet Public Health, 2017, 2(7): e331-e340.
7.	鄭瑩, 龔楊明, 顧凱, 等. 上海市社區居民大腸癌篩查項目. 上海預防醫學, 2016, 28(10): 739-742.
8.	趙麗中, 張偉華, 馬東旺, 等. 天津市大腸癌篩查初步結果分析. 中國腫瘤臨床, 2015, 42(15): 760-764.
9.	李燕, 劉華章, 梁穎茹, 等. 廣州市 2015-2016 年 50~74 歲社區人群大腸癌篩查結果分析. 中華流行病學雜志, 2018, 39(1): 81-85.
10.	Gies A, Bhardwaj M, Stock C, et al. Quantitative fecal immunochemical tests for colorectal cancer screening. Int J Cancer, 2018, 143(2): 234-244.
11.	Lee JK, Liles EG, Bent S, et al. Accuracy of fecal immunochemical tests for colorectal cancer: systematic review and meta-analysis. Ann Intern Med, 2014, 160(3): 171.
12.	Usher-Smith JA, Walter FM, Emery JD, et al. Risk prediction models for colorectal cancer: a systematic review. Cancer Prev Res (Phila), 2016, 9(1): 13-26.
13.	Stegeman I, de Wijkerslooth TR, Stoop EM, et al. Combining risk factors with faecal immunochemical test outcome for selecting CRC screenees for colonoscopy. Gut, 2014, 63(3): 466-471.
14.	Chiu HM, Ching JY, Wu KC, et al. A risk-scoring system combined with a fecal immunochemical test is effective in screening high-risk subjects for early colonoscopy to detect advanced colorectal neoplasms. Gastroenterology, 2016, 150(3): 617-625.e3.
15.	李燕, 劉華章, 林國楨, 等. 廣州市 2015 年大腸癌篩查結果分析. 中國腫瘤, 2016, 25(6): 422-425.
16.	代敏, 石菊芳, 李霓. 中國城市癌癥早診早治項目設計及預期目標. 中華預防醫學雜志, 2013, 47(2): 179-182.
17.	Chen H, Li N, Ren J, et al. Participation and yield of a population-based colorectal cancer screening programme in China. Gut, 2018. doi: 10.1136/gutjnl-2018-317124.
18.	李娟萍, 李小攀, 鄭晶泉, 等. 2013-2016 年上海市浦東新區某社區大腸癌篩查結果分析. 上海預防醫學, 2018, 30(2): 111-114, 125.
19.	蔡善榮, 鄭樹, 周倫, 等. 杭州城市社區自然人群大腸癌篩查實踐. 實用腫瘤雜志, 2006, 21(2): 177-178.
20.	陳宏達, 李霓, 任建松, 等. 中國城市結直腸癌高危人群的結腸鏡篩查依從性及其相關因素分析. 中華預防醫學雜志, 2018, 52(3): 231-237.
21.	Klabunde C, Blom J, Bulliard JL, et al. Participation rates for organized colorectal cancer screening programmes: an international comparison. J Med Screen, 2015, 22(3): 119-126.
22.	Bretthauer M, Kaminski MF, L?berg M, et al. Population-based colonoscopy screening for colorectal cancer: a randomized clinical trial. JAMA Intern Med, 2016, 176(7): 894-902.
23.	Senore C, Inadomi J, Segnan N, et al. Optimising colorectal cancer screening acceptance: a review. Gut, 2015, 64(7): 1158-1177.
24.	Huang JL, Fang Y, Liang M, et al. Approaching the hard-to-reach in organized colorectal cancer screening: an overview of individual, provider and system level coping strategies. AIMS Public Health, 2017, 4(3): 289-300.
25.	Eisinger F, Cals L, Calazel-Benque A, et al. Impact of organised programs on colorectal cancer screening. BMC Cancer, 2008, 8: 104.
26.	Stone EG, Morton SC, Hulscher ME, et al. Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Intern Med, 2002, 136(9): 641-651.
27.	毛阿燕, 石菊芳, 邱五七, 等. 我國城市地區癌癥臨床篩查服務潛在供方服務意愿調查. 中華流行病學雜志, 2018, 39(2): 150-156.
28.	石菊芳, 毛阿燕, 孫宗祥, 等. 我國城市地區癌癥篩查項目人員對篩查工作意愿傾向的多中心調查及政策建議. 中華流行病學雜志, 2018, 39(2): 142-149.
29.	Woodrow C, Rozmovits L, Hewitson P, et al. Bowel cancer screening in England: a qualitative study of GPs’ attitudes and information needs. BMC Fam Pract, 2006, 7: 53.
30.	Honein-AbouHaidar GN, Rabeneck L, Paszat LF, et al. Evaluating the impact of public health initiatives on trends in fecal occult blood test participation in ontario. BMC Cancer, 2014, 14: 537.
31.	Gupta S, Miller S, Koch M, et al. Financial incentives for promoting colorectal cancer screening: a randomized, comparative effectiveness trial. Am J Gastroenterol, 2016, 111(11): 1630-1636.
32.	Tinmouth J, Lansdorp-Vogelaar I, Allison JE. Faecal immunochemical tests versus guaiac faecal occult blood tests: what clinicians and colorectal cancer screening programme organisers need to know. Gut, 2015, 64(8): 1327-1337.
33.	Stoop EM, de Haan MC, de Wijkerslooth TR, et al. Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trial. Lancet Oncol, 2012, 13(1): 55-64.
34.	Adler A, Geiger S, Keil A, et al. Improving compliance to colorectal cancer screening using blood and stool based tests in patients refusing screening colonoscopy in Germany. BMC Gastroenterol, 2014, 14: 183.
35.	Ladabaum U, Mannalithara A. Comparative effectiveness and cost effectiveness of a multitarget stool DNA test to screen for colorectal neoplasia. Gastroenterology, 2016, 151(3): 427-439.e6.
36.	石菊芳, 黃慧瑤, 郭蘭偉, 等. 我國城市大腸癌高危人群對大腸腔鏡篩查的接受度與支付意愿調查. 中華預防醫學雜志, 2015, 49(5): 381-386.
37.	Honein-AbouHaidar GN, Kastner M, Vuong V, et al. Systematic review and meta-study synthesis of qualitative studies evaluating facilitators and barriers to participation in colorectal cancer screening. Cancer Epidemiol Biomarkers Prev, 2016, 25(6): 907-917.
38.	曲利園, 王亞東, 王貴齊, 等. 北京市試點社區居民對大腸癌篩查的看法和對大腸癌認知情況的定性研究. 中國全科醫學, 2007, 10(23): 1935-1937.

1. Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018, 30(1): 1-12.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. Wolf AMD, Fontham ETH, Church TR, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin, 2018, 68(4): 250-281.
4. Zorzi M, Fedeli U, Schievano E, et al. Impact on colorectal cancer mortality of screening programmes based on the faecal immunochemical test. Gut, 2015, 64(5): 784-790.
5. Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ, 2014, 348: g2467.
6. Lew JB, St John DJB, Xu XM,et al. Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: a modelling study. Lancet Public Health, 2017, 2(7): e331-e340.
7. 鄭瑩, 龔楊明, 顧凱, 等. 上海市社區居民大腸癌篩查項目. 上海預防醫學, 2016, 28(10): 739-742.
8. 趙麗中, 張偉華, 馬東旺, 等. 天津市大腸癌篩查初步結果分析. 中國腫瘤臨床, 2015, 42(15): 760-764.
9. 李燕, 劉華章, 梁穎茹, 等. 廣州市 2015-2016 年 50~74 歲社區人群大腸癌篩查結果分析. 中華流行病學雜志, 2018, 39(1): 81-85.
10. Gies A, Bhardwaj M, Stock C, et al. Quantitative fecal immunochemical tests for colorectal cancer screening. Int J Cancer, 2018, 143(2): 234-244.
11. Lee JK, Liles EG, Bent S, et al. Accuracy of fecal immunochemical tests for colorectal cancer: systematic review and meta-analysis. Ann Intern Med, 2014, 160(3): 171.
12. Usher-Smith JA, Walter FM, Emery JD, et al. Risk prediction models for colorectal cancer: a systematic review. Cancer Prev Res (Phila), 2016, 9(1): 13-26.
13. Stegeman I, de Wijkerslooth TR, Stoop EM, et al. Combining risk factors with faecal immunochemical test outcome for selecting CRC screenees for colonoscopy. Gut, 2014, 63(3): 466-471.
14. Chiu HM, Ching JY, Wu KC, et al. A risk-scoring system combined with a fecal immunochemical test is effective in screening high-risk subjects for early colonoscopy to detect advanced colorectal neoplasms. Gastroenterology, 2016, 150(3): 617-625.e3.
15. 李燕, 劉華章, 林國楨, 等. 廣州市 2015 年大腸癌篩查結果分析. 中國腫瘤, 2016, 25(6): 422-425.
16. 代敏, 石菊芳, 李霓. 中國城市癌癥早診早治項目設計及預期目標. 中華預防醫學雜志, 2013, 47(2): 179-182.
17. Chen H, Li N, Ren J, et al. Participation and yield of a population-based colorectal cancer screening programme in China. Gut, 2018. doi: 10.1136/gutjnl-2018-317124.
18. 李娟萍, 李小攀, 鄭晶泉, 等. 2013-2016 年上海市浦東新區某社區大腸癌篩查結果分析. 上海預防醫學, 2018, 30(2): 111-114, 125.
19. 蔡善榮, 鄭樹, 周倫, 等. 杭州城市社區自然人群大腸癌篩查實踐. 實用腫瘤雜志, 2006, 21(2): 177-178.
20. 陳宏達, 李霓, 任建松, 等. 中國城市結直腸癌高危人群的結腸鏡篩查依從性及其相關因素分析. 中華預防醫學雜志, 2018, 52(3): 231-237.
21. Klabunde C, Blom J, Bulliard JL, et al. Participation rates for organized colorectal cancer screening programmes: an international comparison. J Med Screen, 2015, 22(3): 119-126.
22. Bretthauer M, Kaminski MF, L?berg M, et al. Population-based colonoscopy screening for colorectal cancer: a randomized clinical trial. JAMA Intern Med, 2016, 176(7): 894-902.
23. Senore C, Inadomi J, Segnan N, et al. Optimising colorectal cancer screening acceptance: a review. Gut, 2015, 64(7): 1158-1177.
24. Huang JL, Fang Y, Liang M, et al. Approaching the hard-to-reach in organized colorectal cancer screening: an overview of individual, provider and system level coping strategies. AIMS Public Health, 2017, 4(3): 289-300.
25. Eisinger F, Cals L, Calazel-Benque A, et al. Impact of organised programs on colorectal cancer screening. BMC Cancer, 2008, 8: 104.
26. Stone EG, Morton SC, Hulscher ME, et al. Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Intern Med, 2002, 136(9): 641-651.
27. 毛阿燕, 石菊芳, 邱五七, 等. 我國城市地區癌癥臨床篩查服務潛在供方服務意愿調查. 中華流行病學雜志, 2018, 39(2): 150-156.
28. 石菊芳, 毛阿燕, 孫宗祥, 等. 我國城市地區癌癥篩查項目人員對篩查工作意愿傾向的多中心調查及政策建議. 中華流行病學雜志, 2018, 39(2): 142-149.
29. Woodrow C, Rozmovits L, Hewitson P, et al. Bowel cancer screening in England: a qualitative study of GPs’ attitudes and information needs. BMC Fam Pract, 2006, 7: 53.
30. Honein-AbouHaidar GN, Rabeneck L, Paszat LF, et al. Evaluating the impact of public health initiatives on trends in fecal occult blood test participation in ontario. BMC Cancer, 2014, 14: 537.
31. Gupta S, Miller S, Koch M, et al. Financial incentives for promoting colorectal cancer screening: a randomized, comparative effectiveness trial. Am J Gastroenterol, 2016, 111(11): 1630-1636.
32. Tinmouth J, Lansdorp-Vogelaar I, Allison JE. Faecal immunochemical tests versus guaiac faecal occult blood tests: what clinicians and colorectal cancer screening programme organisers need to know. Gut, 2015, 64(8): 1327-1337.
33. Stoop EM, de Haan MC, de Wijkerslooth TR, et al. Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trial. Lancet Oncol, 2012, 13(1): 55-64.
34. Adler A, Geiger S, Keil A, et al. Improving compliance to colorectal cancer screening using blood and stool based tests in patients refusing screening colonoscopy in Germany. BMC Gastroenterol, 2014, 14: 183.
35. Ladabaum U, Mannalithara A. Comparative effectiveness and cost effectiveness of a multitarget stool DNA test to screen for colorectal neoplasia. Gastroenterology, 2016, 151(3): 427-439.e6.
36. 石菊芳, 黃慧瑤, 郭蘭偉, 等. 我國城市大腸癌高危人群對大腸腔鏡篩查的接受度與支付意愿調查. 中華預防醫學雜志, 2015, 49(5): 381-386.
37. Honein-AbouHaidar GN, Kastner M, Vuong V, et al. Systematic review and meta-study synthesis of qualitative studies evaluating facilitators and barriers to participation in colorectal cancer screening. Cancer Epidemiol Biomarkers Prev, 2016, 25(6): 907-917.
38. 曲利園, 王亞東, 王貴齊, 等. 北京市試點社區居民對大腸癌篩查的看法和對大腸癌認知情況的定性研究. 中國全科醫學, 2007, 10(23): 1935-1937.

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