Optimization of colorectal cancer screening in a community of Shanghai

Abstract

The colorectal cancer screening program was implemented in Pujiang community health service center of Minhang District of Shanghai in 2015 (before optimization)and 2016(after optimization). The screening results were compared between 2015 and 2016. In 2015 the positive rate of FOBT was 20%(4 564/22 819), and 707 subjects received further screening colonoscopy with a compliance rate of 15.49%(707/4 564). Colonoscopy detected 4 cases of colorectal cancer, 30 cases of intraepithelial neoplasia, 240 cases of colorectal polyps (including 167 cases of colorectal adenoma) and 6 cases of colorectal inflammatory lesions. In 2016 the positive rate of FOBT was 12.58%(2 947/23 424), 817 subjects received screening colonoscopy with a compliance rate of 27.72%(817/2 947). Colonoscopy detected 5 cases of colorectal cancer, 101 cases of intraepithelial neoplasia, 430 cases of polyps (including 330 cases of colorectal adenoma) and 9 cases of inflammation lesions. There were no significant differences in the detection rates of colorectal cancer, inflammatory and other lesions between 2015 and 2016(P>0.05), the colonoscopy compliance, detection rate of intraepithelial neoplasia and polyps in 2016 were significantly higher than those in 2015(P<0.05). The results suggest that through various measures to optimize the implementation of the colorectal cancer screening, community health service center can improve the colonoscopy compliance in FOBT-positive subjects, the early detection rate of precancerous lesions and polyps in the community. Key words: Colorectal neoplasms; Colonoscopy; Community health centers