Data analysis of residents aged 40-59 in colorectal cancer screening in Pudong New Area, Shanghai, 2013-2023.

To analyse the colorectal cancer (CRC) screening results for residents aged 40–59 years in Shanghai’s Pudong New Area from 2013 to 2023; evaluate the initial screening outcomes, colonoscopy compliance, and the detection rates of intestinal lesions; and provide evidence to support the optimization of local CRC screening programs. This study included residents aged 40–59 years who participated in the CRC screening program in Pudong New Area from 2013 to 2023. A combined initial screening approach, consisting of a risk assessment questionnaire and a faecal occult blood test, was used to identify individuals with positive screening results who were then recommended for colonoscopy. The initial screening positivity rate, colonoscopy compliance rate, and detection rates of various intestinal lesions were calculated. The Cochran‒Armitage trend test was applied to assess temporal trends in these rates across the years of this study. Subgroup analyses stratified by sex and age group were conducted, with intergroup comparisons performed using the χ² test or Fisher’s exact test. A total of 231 574 participants (66.01% female) were included, of whom 36 148 were identified as positive in the initial screen (positivity rate: 15.61%). Among these participants, 10 999 underwent colonoscopy (compliance rate: 30.43%). Colonoscopy detected 3 403 cases of intestinal lesions (detection rate: 30.94%), including 132 cases of CRC, 829 cases of precancerous lesions, and 2 442 cases of other intestinal lesions. Overall, the initial screening positivity rate increased with age and was higher among males than females. Colonoscopy compliance did not differ significantly across age groups but was higher in males than in females. The detection rate of intestinal lesions varied significantly by age group, with males having higher rates than females did. Compared with females, males had 1–2 times higher detection rates for precancerous lesions, polyps, and other intestinal lesions. CRC screening among residents aged 40–59 years in the Pudong New Area contributes to CRC prevention and control. Efforts should focus on improving initial screening participation, particularly among males. Additionally, the current colonoscopy compliance rate among individuals with positive initial screening results (especially among females) remains low and requires further improvement.