Results of screening for colorectal cancer and precancerous lesions in an asymptomatic population in Changchun / 中华健康管理学杂志

ABSTRACT

Objective To study the results of screening for colorectal cancer and precancerous lesions in an asymptomatic population. Methods After excluding menstruating women and patients with acute infectious diarrhea, black stools, purulent and bloody stools, anal fissures, or hemorrhoidal bleeding, 10290 subjects were enrolled for health checkups between July 2015 and July 2017 at the Fourth Hospital of Jilin University. A two-step method using a questionnaire and an immunochemical fecal occult blood test for primary screening and electronic colonoscopy for diagnostic screening was employed. When a lesion was located during electronic colonoscopy, a biopsy was performed for pathology. The detection rates for colorectal cancer, adenomas, inflammatory bowel disease, and polyps were analyzed according to age and sex. Prevalence was assessed using the χ2 test, and statistical significance level was set at P<0.05. Results Primary screening was positive in 523 cases (5.1％, 448 males and 75 females). There were significant differences in detection rates by sex (χ2=4.540, P=0.033). Of 523 positive cases, 154 (29.4％, 133 males and 21 females) underwent enteroscopy. There were significant differences in colonoscopy rates by age group (χ2=10.734, P=0.001). The total detection rate with colonoscopy was 61.7％(95/154), with a colorectal cancer detection rate of 3.9％(6/154) and an adenoma detection rate of 35.7％(55/154). The adenoma detection rate in males [39.8％(53/133)] was higher than in females [9.5％(2/21)], and the difference was statistically significant (χ2=7.265, P=0.007). There were significant differences in the adenoma detection rates (χ2=5.879, P=0.015), polyp detection rate (χ2=6.669, P=0.010), and total lesion detection rate (χ2=21.735, P<0.001) among all age groups. Conclusion Colorectal cancer screening for asymptomatic individuals can be performed at different curable disease stages. This approach can reduce the delay in treatment upon disease progression, as well as improve survival rate.