ABSTRACT
Objective To collect and summarize the opinions of experts on the improvement of China's disease prevention and control system published in the public media, so as to provide reference for the relevant construction planning of the government. Methods: Articles were collected from January to May, 2020, which were published on Chinese mainstream media. Based on the analysis of literature and the basic characteristics of experts, Analytic hierarchy process (AHP) was used to summarize the construction points of experts in different construction fields. Results: A total of 19 opinion articles were finally included in the study and 29 experts were involved. The suggestions of experts on the construction of China's disease prevention and control system were summarized into four aspects. Conclusion: The COVID-19 pandemic is a challenge to the existing public health epidemic prevention and control system in China, and also an important opportunity for the development and construction of the related system.
ABSTRACT
The health literacy refers to the ability of individuals to acquire and understand basic health information and services and use them to make the right decisions to maintain and promote their health. Health literacy data focusing on cancer prevention and control was limited in China. In order to understand the health literacy and awareness of cancer risk factors and the cancer screening, early diagnosis and treatment in Chinese urban residents and compare the effect of different stages of the cancer intervention, the Cancer Screening Program in Urban China (CanSPUC) program, supported by the National Key Public Health Program, conducted a survey on the health literacy of the cancer prevention and treatment among urban residents in 16 provinces nationwide from 2015 to 2017. Four subgroups were designed in this survey, including (1) general population who have never participated in any cancer screening programs at a community-level; (2) individuals who have previously attended the CanSPUC program for cancer risk assessment or screening intervention; (3) cancer patients who were receiving treatment in local hospitals; (4) a special group from employees of government and public institutions (non-health system), state-owned enterprises and private enterprises (to have better understand on the impact of socioeconomic factors). The self-designed questionnaire covered six parts, including basic information, consciousness of common risk factors to cancer, awareness of early detection, awareness of early diagnosis, awareness of early treatment, and the needs and approaches for knowledge of cancer prevention and treatment. A total of 32 257 individuals were included in the final analyses. This paper landscaped the overall design of the survey, including participants, domains of the instrument, quality control, basic characteristics of the included individuals. These descriptions are applicable to each individual report of the current special issue of "Health Literacy of Cancer Control in Urban China" and future reports, in which more detailed results are and will be reported. The findings of this survey could provide some useful implications for similar researches in the future.
ABSTRACT
Objective@#To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model.@*Results@#The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all P values <0.05).@*Conclusion@#There was a high demand for the cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017. The main access to the knowledge is from the radio or television. The occupation, marital status, annual household income, residential region, health status and risk of disease were the main factors of the demand of the cancer prevention and treatment knowledge.
ABSTRACT
Objective@#To understand the health literacy of the cancer prevention and treatment among urban residents of China, and explore the related factors.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The health literacy of the cancer prevention, early discovery, early diagnosis, early treatment and the demands of cancer prevention and treatment knowledge was analyzed. The level of health literacy among different groups were calculated and compared. The binary logistic regression model was used to analyze the influencing factors of the health literacy of the cancer prevention and treatment.@*Results@#The level of health literacy of the cancer prevention and treatment was 56.97% among all study population; in each group it was 55.01% for community residents, 59.08% for cancer risk assessment/screening population, 61.99% for cancer patients and 57.31% for occupational population, respectively (P<0.001). The level of health literacy of the cancer prevention and treatment of residents aged 50 to 69 years old, other occupational groups, unmarried, the central and western region residents and the group with unclear self-assessment of cancer risk was significantly lower than that of residents younger than 40 years old, personnel of public institutions/civil servants, married, the eastern region residents and the group whose self-assessment without cancer risk (P<0.05) . The level of health literacy of cancer prevention and treatment of females, people who went to high school or over, cancer risk assessment/screening population, cancer patients and occupational population was significantly higher than that of males, people who had an education level of primary school or below and community residents (P<0.05) .@*Conclusion@#The health literacy of the cancer prevention and treatment of urban residents in China was relatively high, but there was still room for improvement. Gender, age, educational level, occupation, region, marital status, self-assessment of cancer risk, and type of respondents were the key influencing factors of the health literacy of the cancer prevention and treatment. Male, 50-69 years old, lower educational level, central and western regions, unclear cancer risk self-assessment, and without specific environmental exposure to cancer prevention and treatment knowledge or related risk factors were the characteristics of the key intervention group of the health literacy of the cancer prevention and treatment.
ABSTRACT
Objective@#To understand the consciousness of the cancer early treatment and its demographic and socioeconomic factors.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment.@*Results@#With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (P<0.001). If the immediate family members were diagnosed as precancer or cancer, people who would encourage their family members to receive early treatment in the four groups accounted for 91.96%, 91.94%, 92.44% and 91.55%, respectively (P<0.001). The company employees, annual household income with 40 000 yuan and more and other three groups had a relatively better consciousness of the cancer early treatment (P<0.05). Male, widowed, unemployed and from the central and western regions had a relatively worse consciousness of the cancer early treatment (P<0.05).@*Conclusion@#Residents in urban China participants had a good consciousness of the cancer early treatment. The marital status, occupation, annual household income and residential regions were major factors related to the consciousness of the cancer early treatment.
ABSTRACT
Objective@#To understand the consciousness of the cancer early diagnosis among urban residents and identify the related factors from 2015 to 2017.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The general demographic characteristics, the consciousness of the cancer early diagnosis (whether people would have a willingness or encourage their relatives/friends to confirm the abnormal results once which were detected from the physical examination) and other information were collected by using the self-designed questionnaire. The non-conditional logistic regression model was used to identify the relateol factors related to the consciousness of the cancer early diagnosis.@*Results@#As for residents with abnormal result from the physical examination, 89.29% (28 802) of residents would choose to seek medical treatment for further diagnosis. If their relatives/friends had abnormal results from the physical examination, 89.55% (28 886) of residents would encourage their relatives/friends to confirm the diagnosis in time. The non-conditional logistic regression model analysis showed that compared with the public institution staff/civil servants, annual household income less than 20 000 CNY, the western region and the cancer risk assessment/screening intervention population, the company staff, annual household income about 40 000 CNY and more, and the residents from the middle and eastern region had a stronger consciousness to seek further diagnosis; while the unemployed residents and community residents were less likely to seek further diagnosis (P<0.05).@*Conclusions@#From 2015 to 2017, the Chinese urban residents had a good consciousness of the cancer early diagnosis. Occupation, annual household income, residential region and population group were related to the consciousness of the cancer early diagnosis.
ABSTRACT
Objective@#To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years.@*Results@#The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05).@*Conclusion@#From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.
ABSTRACT
Objective@#To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors.@*Results@#The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05).@*Conclusion@#The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.
ABSTRACT
Objective@#To explore the establishment of an evaluation indicator system for disease prevention and control workload at public hospitals, based on the current situation of disease prevention and control work undertaken by public hospitals of and above secondary level in Beijing, and to provide evaluation assistance for them to do better in this regard.@*Methods@#This research was based on our pervious study of the current situation description of disease prevention and control work undertaken by public hospitals in Beijing, by which the contents of routine disease prevention and control work at hospitals have been initially established. The unit strength of each work was consulted, and the disease prevention and control work was classified according to the results. Meanwhile the consistency test of the work intensity within the category was carried out. After integration, the classification and evaluation indicator of disease prevention and control work in public hospitals of and above secondary level in Beijing was finally established.@*Results@#The workload evaluation indicator system was divided into eight parts: report work, report quality control work, monitoring work, training work, work of public health related clinical diagnosis and treatment, work of clinical examination and vaccination, work of sampling and testing and public health related consultation work. The work intensity of each category ranged from 4.78 to 7.34.@*Conclusions@#The evaluation indicator system of workload is suitable for the evaluation of basic works. The unified transformation of workload by using the value of work intensity is conducive to management evaluation, but the limitation of the indicators exists in time and region, making it necessary to adjust by the local specific situation at the promotion and application level.
ABSTRACT
Objective@#To investigate the implementation of disease prevention and control services at tertiary public general hospitals in Beijing for providing evidences to explore and build a scientific evaluation model of disease control service in medical institutions.@*Methods@#June to September 2018, through a questionnaire survey of 50 tertiary public general hospitals in Beijing, a descriptive analysis was made on the department setting, personnel allocation and service provision status of disease prevention and control at tertiary public general hospitals in Beijing.@*Results@#Among the 44 investigated public tertiary general hospitals, 26(59.1%) medical institutions have set up departments of disease prevention and control. The average staffing of 44 hospitals was 5.8 persons for the department. Professional composition of the staff was mostly nursing and clinical disciplines, and the academic and professional titles were mostly undergraduate and intermediate degrees respectively. Overall performance of disease prevention and control services in public tertiary general hospitals was satisfactory. The work was well carried out in communicable disease control and death-surveillance management, namely in immunoprophylaxis, chronic noncommunicable diseases and injury monitoring, which varies widely in mental health services, occupational health management, environmental and health monitoring and other functions.@*Conclusions@#Professional ability and management level of personnel still need to be improved. We should further clarify the joint prevention and control mechanism of the " Three-in-one" nature of disease control institutions, medical institutions and communities, promote the combination of medical treatment and prevention, and explore the classification and grading evaluation of disease control work based on the types and quantity requirements of disease prevention and control services undertaken by hospitals, so as to effectively improve the level of disease control services in hospitals.
ABSTRACT
An assessment is a key to public health management. This article reviewed the experiences and researches of assessment on public-health system, as well as public health service quality of medical institutions in America, the United Kingdom and Australia among other countries. On such basis, suggestions were provided on assessments of public health service in China, in order to help the government to improve its indicator evaluation system.
ABSTRACT
Hospitals, especially public hospitals, are an important part of the public health service system. To clarify public health functions of secondary and tertiary public hospitals in China and provide evidences for related health policy decisions, this article introduced the public health services of hospitals in the United States, Britain, Australia and Canada, and then analyzed public health functions of secondary and tertiary public hospitals in China through literature review and case study. The authors summed up eight kinds of public health service functions, and put forward policy advices to promote the performance of public health functions of public hospitals in China.
ABSTRACT
Objective To explore the establishment of an evaluation indicator system for disease prevention and control workload at public hospitals, based on the current situation of disease prevention and control work undertaken by public hospitals of and above secondary level in Beijing, and to provide evaluation assistance for them to do better in this regard.Methods This research was based on our pervious study of the current situation description of disease prevention and control work undertaken by public hospitals in Beijing, by which the contents of routine disease prevention and control work at hospitals have been initially established. The unit strength of each work was consulted, and the disease prevention and control work was classified according to the results. Meanwhile the consistency test of the work intensity within the category was carried out. After integration, the classification and evaluation indicator of disease prevention and control work in public hospitals of and above secondary level in Beijing was finally established. Results The workload evaluation indicator system was divided into eight parts:report work, report quality control work, monitoring work, training work, work of public health related clinical diagnosis and treatment, work of clinical examination and vaccination, work of sampling and testing and public health related consultation work. The work intensity of each category ranged from 4.78 to 7.34. Conclusions The evaluation indicator system of workload is suitable for the evaluation of basic works. The unified transformation of workload by using the value of work intensity is conducive to management evaluation, but the limitation of the indicators exists in time and region, making it necessary to adjust by the local specific situation at the promotion and application level.
ABSTRACT
Objective To investigate the implementation of disease prevention and control services at tertiary public general hospitals in Beijing for providing evidences to explore and build a scientific evaluation model of disease control service in medical institutions. Methods June to September 2018, through a questionnaire survey of 50 tertiary public general hospitals in Beijing, a descriptive analysis was made on the department setting, personnel allocation and service provision status of disease prevention and control at tertiary public general hospitals in Beijing. Results Among the 44 investigated public tertiary general hospitals, 26 ( 59.1% ) medical institutions have set up departments of disease prevention and control. The average staffing of 44 hospitals was 5.8 persons for the department. Professional composition of the staff was mostly nursing and clinical disciplines, and the academic and professional titles were mostly undergraduate and intermediate degrees respectively. Overall performance of disease prevention and control services in public tertiary general hospitals was satisfactory. The work was well carried out in communicable disease control and death-surveillance management, namely in immunoprophylaxis, chronic noncommunicable diseases and injury monitoring, which varies widely in mental health services, occupational health management, environmental and health monitoring and other functions. Conclusions Professional ability and management level of personnel still need to be improved. We should further clarify the joint prevention and control mechanism of the " Three-in-one" nature of disease control institutions, medical institutions and communities, promote the combination of medical treatment and prevention, and explore the classification and grading evaluation of disease control work based on the types and quantity requirements of disease prevention and control services undertaken by hospitals, so as to effectively improve the level of disease control services in hospitals.
ABSTRACT
An assessment is a key to public health management. This article reviewed the experiences and researches of assessment on public-health system, as well as public health service quality of medical institutions in America, the United Kingdom and Australia among other countries. On such basis, suggestions were provided on assessments of public health service in China, in order to help the government to improve its indicator evaluation system.
ABSTRACT
Hospitals, especially public hospitals, are an important part of the public health service system. To clarify public health functions of secondary and tertiary public hospitals in China and provide evidences for related health policy decisions, this article introduced the public health services of hospitals in the United States, Britain, Australia and Canada, and then analyzed public health functions of secondary and tertiary public hospitals in China through literature review and case study. The authors summed up eight kinds of public health service functions, and put forward policy advices to promote the performance of public health functions of public hospitals in China.
ABSTRACT
In a real-world running of cancer screening programs or intervention strategies,multiple influencing factors need to be considered other than the effectiveness and cost-effectiveness.The articles in this special issue summarize the main findings related to sustainability of cancer screening program in urban China from four perspectives of cancer screening service,including actual supplier,potential supplier,actual demander and potential demander.These evidences are expected to provide references for decision-making on suitable strategies and running mechanism for large-scale cancer screening program in local populations.
ABSTRACT
In a real-world running of cancer screening programs or intervention strategies,multiple influencing factors need to be considered other than the effectiveness and cost-effectiveness.The articles in this special issue summarize the main findings related to sustainability of cancer screening program in urban China from four perspectives of cancer screening service,including actual supplier,potential supplier,actual demander and potential demander.These evidences are expected to provide references for decision-making on suitable strategies and running mechanism for large-scale cancer screening program in local populations.
ABSTRACT
Objective@#To parameterize the 1-year transition probabilities between different health status of the natural history of breast cancer based on the data of randomized controlled trial of X-ray mammography screening worldwide.@*Methods@#Based on the breast cancer screening randomized controlled trials defined by a mammography screening review from the Cochrane 2013 and the International Agency for Research on Cancer, a systematic review was initiated in PubMed by searching names of the key investigators of the trials, combined with the diseases, screening intervention and outcome indicators. If applicable, all the original cumulative incidence rates were converted into one-year transition rate, using the life-table approach considering time length of follow-up.@*Results@#A total of 23 reports from 9 RCTs were included. The data on transition rate between the healthy status to precancerous lesions was absent. The 1-year transition rate from health to carcinoma in situ was 17.78 to 50.21 per 100 000 persons in the intervention group and 9.16 to 26.84 per 100 000 persons in the control group. Correspondingly, the 1-year transition rate from health to breast cancer (including carcinoma in situ and invasive cancer) were estimated as 143.75 to 316.97 per 100 000 persons in the intervention group, and 141.45 to 288.84 per 100 000 persons in the control group. Furthermore, the transition rate from the healthy status to invasive breast cancer was 159.79 to 264.60 per 100 000 persons in intervention group and 170.12 to 255.33 per 100 000 persons in control group. The transition rate from carcinoma in situ to invasive breast cancer varied among different pathological types.@*Conclusions@#The most common natural history states of reported by the included trials involved the full healthy status, carcinoma in situ and invasive breast cancer. The findings of transition rates between different health statuses will be informative for future model development of natural history studies of breast cancer. Information in relation to breast precancerous lesions still limited and needs to be further addressed.
ABSTRACT
<p><b>OBJECTIVE</b>To survey the acceptance and willingness-to-pay for colorectal cancer colonoscopy screening among high risk populations in urban China.</p><p><b>METHODS</b>From 2012 to 2013, a Cancer Screening Program in Urban China (CanSPUC) was initiated in 9 provinces, the current survey was conducted among those participants who were evaluated as "high risk for colorectal cancer" by a risk-factor-evaluation-model (community-based) and then went through a colonoscopy screening procedure (hospital-based). All the data were obtained through a questionnaire-based interview (face-to-face or self-completed), mainly focusing on the acceptance and willingness-to-pay of the participants for colorectal colonoscopy screening.</p><p><b>RESULTS</b>The current analysis included a total of 1 624 participants, with an median age of 55.0 years (P25 = 49.0, P75 = 61.0 years) and an annual income per capita of 17 thousand (range: 10-25 thousand) Chinese Yuan (CNY), 42.8% (695/1 624) of whom were males. Of all the participants, 87.0% (1 414/1 624) could totally or substantially accept the colonoscopy screening, particularly in those at higher education level (junior high school: OR = 0.34, 95% CI: 0.22-0.52; high school OR = 0.41, 95% CI: 0.26-0.66; college or over OR = 0.35, 95% CI: 0.20-0.59). Of all the participants, 13.0% (210/1 624) could not or hardly accept it, particularly in those with older age (60-69 years) (OR = 1.48, 95% CI: 1.06-2.07), not in marriage (OR = 2.15, 95% CI: 1.25-3.70) or with family member(s) to raise (OR = 1.60, 95% CI: 1.17-2.20). 1 388 (85.5%) of all the participants had willingness-to-pay for a long-term colonoscopy screening service, particularly in those working in public (OR = 0.61, 95% CI: 0.44-0.84) or enterprise sectors (OR = 0.60, 95% CI: 0.38-0.94), but 82.3% (1 141/1 386) of whom would only pay less than 100 CNY; 14.5% (236/1 624) of total had no willingness-to-pay, particularly in those living in areas with moderate (OR = 4.08, 95% CI: 2.75-6.33) or high GDP per capita (OR = 3.26, 95% CI: 2.11-4.92), or with an absence of willingness-to-pay for colonoscopy screening (OR = 3.98, 95% CI: 2.81-5.65).</p><p><b>CONCLUSIONS</b>Although a larger community-based colorectal cancer screening program was warranted to examine the extrapolation of these findings, it suggested that the acceptance for colorectal cancer colonoscopy screening among the selected high-risk populations was considerable. The willing-to-pay was relatively high but the amount of payment was limited, the indicated subgroups with potentially less acceptance or willingness need to be more focused in the future to reach a higher participation rate. The data will also be informative in integrating the screening service into the local health insurance system.</p>