Colonoscopy compliance and diagnostic yield in a large population-based colorectal cancer screening programme

• DOI: 10.1007/s00384-023-04517-3
• Publication Date: 2023-09-13T03:21:35Z
• Authors: Xinzhu Zhao; Shuyuan Wang; Zhen Yuan; Suying Yan; Wenwen Pang; Xinyu Liu; Wanting Wang; Ben Yi; Qiurong Han; Qinghuai Zhang; Xipeng Zhang; Chunze Zhang
• Keywords: Cell Movement; Research; Neoplasms; Humans; Educational Status; Colonoscopy; 16. Peace & justice; Early Detection of Cancer; 3. Good health; Aged

Abstract Objectives With the intention of providing a reference for secondary prevention, our study provides some insight on diagnostic yield of factors influencing compliance with colonoscopy and the presence of advanced adenomas (AA).

Methods We conducted large-scale CRC screening among local Tianjin residents aged 40–75 years between 2012 and 2019. A high-risk factor questionnaire (HRFQ) was distributed to each participant, followed by the performance of a fecal immunochemical test (FIT). Participants who tested positively for any of these items were advised to undergo a colonoscopy. Relevant basic information was collected from participants during CRC screening, and the screening data were sorted and analysed.

Results A total of 5,670,924 people participated in CRC screening by the end of 2019, including 275,708 people in the high-risk group, and 74,685 (27.1%) people who underwent colonoscopy. The results of the logistic regression model demonstrated that participants with a history of mucous bloody stool (OR = 8.20, 95% CI: 7.92, 8.50, p < 0.001), chronic diarrhea (OR = 5.73, 95% CI: 5.57, 5.89, p < 0.001), and higher level of education (OR = 1.87, 95% CI: 1.80, 1.93, p < 0.001) were more likely to comply with a colonoscopy. Several factors including age (70–75 years old:OR = 3.72, 95% CI: 2.71, 5.10, p < 0.001), and FIT( +) (OR = 1.65, 95% CI: 1.42,1.90, p < 0.001) were identified to be associated with the presence of AA.

Conclusions Increased compliance with colonoscopy is urgently needed. Our findings can inform the design of future effective large-scale population-based CRC screening programmes.