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.	郑莹, 龚杨明, 顾凯, 等. 上海市社区居民大肠癌筛查项目. 上海预防医学, 2016, 28(10): 739-742.
8.	赵丽中, 张伟华, 马东旺, 等. 天津市大肠癌筛查初步结果分析. 中国肿瘤临床, 2015, 42(15): 760-764.
9.	李燕, 刘华章, 梁颖茹, 等. 广州市 2015-2016 年 50~74 岁社区人群大肠癌筛查结果分析. 中华流行病学杂志, 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, 刘华章, 林国桢, 等. 广州市 2015 年大肠癌筛查结果分析. 中国肿瘤, 2016, 25(6): 422-425.
16.	代敏, 石菊芳, 李霓. 中国城市癌症早诊早治项目设计及预期目标. 中华预防医学杂志, 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, 郑晶泉, 等. 2013-2016 年上海市浦东新区某社区大肠癌筛查结果分析. 上海预防医学, 2018, 30(2): 111-114, 125.
19.	蔡善荣, 郑树, 周伦, 等. 杭州城市社区自然人群大肠癌筛查实践. 实用肿瘤杂志, 2006, 21(2): 177-178.
20.	陈宏达, 李霓, 任建松, 等. 中国城市结直肠癌高危人群的结肠镜筛查依从性及其相关因素分析. 中华预防医学杂志, 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, Løberg 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. 我国城市地区癌症临床筛查服务潜在供方服务意愿调查. 中华流行病学杂志, 2018, 39(2): 150-156.
28.	石菊芳, 毛阿燕, 孙宗祥, 等. 我国城市地区癌症筛查项目人员对筛查工作意愿倾向的多中心调查及政策建议. 中华流行病学杂志, 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, 黄慧瑶, 郭兰伟, 等. 我国城市大肠癌高危人群对大肠腔镜筛查的接受度与支付意愿调查. 中华预防医学杂志, 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.	曲利园, 王亚东, 王贵齐, 等. 北京市试点社区居民对大肠癌筛查的看法和对大肠癌认知情况的定性研究. 中国全科医学, 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. 郑莹, 龚杨明, 顾凯, 等. 上海市社区居民大肠癌筛查项目. 上海预防医学, 2016, 28(10): 739-742.
8. 赵丽中, 张伟华, 马东旺, 等. 天津市大肠癌筛查初步结果分析. 中国肿瘤临床, 2015, 42(15): 760-764.
9. 李燕, 刘华章, 梁颖茹, 等. 广州市 2015-2016 年 50~74 岁社区人群大肠癌筛查结果分析. 中华流行病学杂志, 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, 刘华章, 林国桢, 等. 广州市 2015 年大肠癌筛查结果分析. 中国肿瘤, 2016, 25(6): 422-425.
16. 代敏, 石菊芳, 李霓. 中国城市癌症早诊早治项目设计及预期目标. 中华预防医学杂志, 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, 郑晶泉, 等. 2013-2016 年上海市浦东新区某社区大肠癌筛查结果分析. 上海预防医学, 2018, 30(2): 111-114, 125.
19. 蔡善荣, 郑树, 周伦, 等. 杭州城市社区自然人群大肠癌筛查实践. 实用肿瘤杂志, 2006, 21(2): 177-178.
20. 陈宏达, 李霓, 任建松, 等. 中国城市结直肠癌高危人群的结肠镜筛查依从性及其相关因素分析. 中华预防医学杂志, 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, Løberg 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. 我国城市地区癌症临床筛查服务潜在供方服务意愿调查. 中华流行病学杂志, 2018, 39(2): 150-156.
28. 石菊芳, 毛阿燕, 孙宗祥, 等. 我国城市地区癌症筛查项目人员对筛查工作意愿倾向的多中心调查及政策建议. 中华流行病学杂志, 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, 黄慧瑶, 郭兰伟, 等. 我国城市大肠癌高危人群对大肠腔镜筛查的接受度与支付意愿调查. 中华预防医学杂志, 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. 曲利园, 王亚东, 王贵齐, 等. 北京市试点社区居民对大肠癌筛查的看法和对大肠癌认知情况的定性研究. 中国全科医学, 2007, 10(23): 1935-1937.

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