ABSTRACT
Objective@#To compare the effectiveness of qualitative and quantitative fecal immunochemical tests (FIT) in identifying colorectal cancer, so as to provide insights into perfecting screening strategies for colorectal cancer.@*Methods@#Participants in the Colorectal Cancer Screening Program for Key Populations in Zhejiang Province from May 2020 to December 2021 were recruited, and their demographic information, lifestyle and disease history were collected through a questionnaire survey. Qualitative or quantitative FIT along with a questionnaire-based risk assessment were employed as the initial screening tests. Individuals who were positive in any FIT or had high-risk assessment results were required to attend a subsequent colonoscopy examination. The positive rate, detection rate of colorectal cancer, positive predictive value and number of colonoscopies required were compared between qualitative and quantitative FITs, and stratified analyses by gender and age were conducted.@*Results@#Totally 4 099 769 participants were included. The qualitative FIT group included 3 574 917 individuals, yielding a positive rate of 11.35%, a detection rate of 1.19%, a positive predictive value of 0.48% and 83.84 colonoscopies required to detect one cancer case. The quantitative FIT group involved 524 852 individuals, yielding a positive rate of 6.70%, a detection rate of 2.31%, a positive predictive value of 1.01% and 43.23 colonoscopies required to detect one cancer case. The quantitative FIT group showed significantly higher detection rate of colorectal cancer, higher positive predictive value and less number of colonoscopies required compared to the qualitative FIT group (all P<0.05). The same results were obtained after stratification by gender and age.@*Conclusion@#Compared to qualitative FIT, quantitative FIT improves the detection of colorectal cancer and reduces the workload of colonoscopy examinations, making it more suitable for colorectal cancer screening in large-scale populations.
ABSTRACT
Objective@#To investigate the current awareness of core knowledge about cancer prevention and its influencing factors among residents in Zhejiang Province, in order to provide a reference for formulating provincial health education strategies of cancer prevention.@*Methods @#From November 2019 to October 2020, the permanent residents aged 18-74 years in Zhejiang Province were selected using multi-stage stratified sampling method. A questionnaire was designed according to Core Information and Knowledge on Cancer Prevention to collect general information, health status, and awareness of core knowledge about cancer prevention. The multivariate logistic regression model was used to analyze the influencing factors. @*Results@#Among 6 974 valid respondents, 3 139 ( 45.01% ) were males and 3 835 ( 54.99% ) were females. The overall awareness rate of core knowledge about cancer prevention was 74.66%; the awareness rates of basic knowledge, risk factors and primary prevention, screening and early diagnosis as well as treatment and rehabilitation were 79.08%, 80.83%, 76.08% and 82.99%, respectively. The multivariate logistic regression analysis showed that the residents who were in rural areas ( OR=0.659, 95%CI: 0.585-0.743 ), ≥45 years old ( OR: 0.794-0.801, 95%CI: 0.655-0.981 ) and with obesity (OR=0.531, 95%CI: 0.436-0.647) had lower awareness rates, while the residents who were with an educational level of junior high school/technical school/senior high school or above ( OR: 1.390-4.361, 95%CI: 1.208-5.600 ), married (OR=1.414, 95%CI: 1.142-1.752), administrative/technical personnel ( OR=2.602, 95%CI: 2.005-3.377 ), service staff/private business owners ( OR=1.368, 95%CI: 1.111-1.684), retired ( OR=1.345, 95%CI: 1.105-1.639 ) and others ( OR=1.542, 95%CI: 1.295-1.838 ), and with experience of cancer screening or examination ( OR=1.267, 95%CI: 1.123-1.428 ) had higher awareness rates. @*Conclusions@#The awareness rate of core knowledge about cancer prevention in Zhejiang Province is 74.66%. Health education for the residents aged ≥45 years, living in rural areas, having low educational levels, and having obesity should be
ABSTRACT
Objectives: To analyze lung cancer data of patients who are registered in Zhejiang province from 2010 to 2014 and describe the prevalence and mortality of lung cancer in residents of Zhejiang province, so as to provide a reference basis for the government and health administrative departments to formulate a strategy of cancer prevention and treatment. Methods: According to the report of 14 tumor registries of Zhejiang province from 2010 to 2014 in urban and rural areas, lung cancer incidence and mortality were calculated by gender, age, and urban or rural areas, respectively. The population structure from the 2000 national census and Segi's standard population was used to calculate the standardized rates and indicators such as the 0-74-year-old accumulation rates and 35-64-year-old truncation rates. Results: In 2010-2014, there were 37,227 new cases of malignant tumors of the trachea, bronchi, and lungs in Zhejiang cancer registration areas (which are referred to as lung cancer in this article; ICD10 was coded as c33-c34), with the crude incidence rates of 63.55 per 100,000, 35.73 per 100,000 for ASR China, and 35.54 per 100,000 for ASR world, accounting for 18.85% of all cancer cases. The cu-mulative rate of incidence in those aged 0-74 years was 4.44%. Of the new cases, 25,608 were men and 11,619 were women. The ASR China in male was as 2.26 times high as that in female. The ASR China in rural areas was as 1.12 times high as that in urban areas. There were 31,772 deaths in 2010-2014, with the crude mortality rates of 54.24 per 100,000, 29.39 per 100,000 for ASR China, and 29.05 per 100,000 for ASR world, accounting for 29.22% of all cancer deaths. Of the deaths, 22,796 were men and 8,976 were women. The ASR China in male was as 2.70 times high as that in female. The ASR China in rural areas was as 1.05 times high as that in urban areas. The age-specific incidence and mortality rates were relatively low before 40 years old, and increased dramatically after 40 years old, then reached peak at the age of 80 years old. Rates in male were generally higher than those in female. The age-specific incidence and mortality rates varied in urban and rural areas with similar curves. Conclusions: Lung cancer was the most common malignancy in Zhejiang province, and its incidence and mortality are both in the first place of all cancers . With the relatively high burden of disease, lung cancer should be regarded as one of the key malignant tumors while developing strategies for cancer prevention and treatment.