ArticleBMC cancer2019
Effects of subitems in the colorectal cancer screening protocol on the Chinese colorectal cancer screening program: an analysis based on natural community screening results.
Article in BMC cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of colorectal cancer, 2024 update.Cancer communications (London, England) · 2025Guideline
- National and subnational incidence, mortality and associated factors of colorectal cancer in China: A systematic analysis and modelling study.Journal of global health · 2023Pooled it
- Factors associated with false fecal immunochemical test results in colorectal cancer screening.World journal of gastrointestinal oncology · 2025Article
- Colonoscopy outcomes of primary screening negative participants highlight the missed diagnosis problem of colorectal cancer screening: an observational study from Yuexiu district in Guangzhou, China.Frontiers in oncology · 2025Article
- Trends in colorectal cancer screening compliance and incidence among 60- to 74-year-olds in China.Cancer medicine · 2024Article
- A qualitative interview study on colorectal cancer screening in China.Frontiers in medicine · 2024Article
- Application of the 'online assessment + FOBT at home' to improve participation and the efficacy of opportunistic screening for colorectal cancer: a retrospective cohort study.BMC public health · 2023Article
- Age- and sex-stratified detection rates and associated factors of colorectal neoplasia in the Tianjin colorectal cancer screening program from 2012 to 2020.BMC gastroenterology · 2023Article
- Postponing colonoscopy for 6 months in high-risk population increases colorectal cancer detection in China.Cancer medicine · 2023Article
- Modifiable lifestyle factors have a larger contribution to colorectal neoplasms than family history.BMC cancer · 2022Article
- Out-of-pocket medical expenditure and associated factors of advanced colorectal cancer in China: a multi-center cross-sectional study.Annals of translational medicine · 2022Article
- Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study.Annals of translational medicine · 2022Article
- Colorectal Cancer Screening With High Risk-Factor Questionnaire and Fecal Immunochemical Tests Among 5, 947, 986 Asymptomatic Population: A Population-Based Study.Frontiers in oncology · 2022Article
- Must pilots permanently quit flying career after treatment for colorectal cancer? - Medical waiver for Air Force pilots with colorectal cancer: Three case reports.World journal of clinical cases · 2020Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundTo date, no single colorectal cancer (CRC) screening strategy has been determined to be applicable worldwide. In China, a CRC screening protocol that combines double fecal immunochemical tests (FITs) and a high-risk factor questionnaire (HRFQ) as the first stage of screening and colonoscopy as the second stage of screening (scenario A) was adapted by the Chinese Ministry of Health in 2006. However, applying this CRC screening protocol nationally remains difficult because its effectiveness and convenience are controversial. This study evaluated the effects of subitems of the CRC screening protocol in China.
methodsCRC screening results (scenario A) from Jiashan County, China, (2007-2009) were used to analyze the detection rates of CRC and advanced neoplasms as well as the cost-effectiveness of the protocol. Scenario A was divided into scenarios B-G (by selecting some items at the first stage of screening) for analysis.
resultsCompared with scenario A, removing the whole HRFQ (scenario F) reduced advanced neoplasm and adenoma detections by 29.8 and 41.2%, respectively, whereas the whole HRFQ accounted for 10.1% of the total screening cost. Removing FITs (scenario G) reduced CRC, advanced neoplasm and adenoma detections by 71.8, 56.9 and 47.7%, respectively, and the costs per case of CRC and advanced neoplasm were 82.0 and 19.1% higher, respectively, than those in scenario A. In scenarios B-E (deleting some high-risk factor questions on the HRFQ), the odds ratios (ORs) of the detection rates and costs per CRC, advanced neoplasm, adenoma, and neoplasm case were near 1.00. Scenarios C and D reduced the high-risk population and total screening costs by less than 6.0 and 4.1%, respectively. Scenarios E and B (FITs and a personal history of cancer or colorectal adenoma were reserved) reduced the high-risk population by 17.6 and 24.2% and the total screening costs by 11.2 and 15.4%, respectively, while the numbers of CRC cases were not missed, and advanced neoplasms detected decreased by only 5 and 11%, respectively.
conclusionThe results of this study demonstrate that FITs and a personal history of colorectal adenoma are the most effective items in the Chinese CRC screening protocol.
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