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| Meta-analysis on the effect of colorectal cancer screening in China |
| YUAN Ping MA Xingfan |
| Department of Central Laboratory, Peking University Shougang Hospital, Beijing 100144, China |
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Abstract Objective To systematically evaluate the effectiveness of screening for colorectal cancer in China by questionnaire survey combined with fecal occult blood tests. Methods Computer search was conducted on CNKI, WanFang, PubMed, EBSCO and other Chinese and foreign language databases, supplemented by reference tracing and manual search methods, to find literatures with a population of more than 5000 in the primary screening population of colorectal cancer. The retrieval time was from the database construction to June 2016. R3.3.1 software was used for meta-analysis. The screening effect was analyzed by the initial screening positive rate, the detection rate and early diagnosis rate of colorectal lesions and the detection rate of colorectal cancer, and the detection rate of colorectal lesions was analyzed by stratification. Results In the end, 28 articles were included, and a total of 3 398 895 people were screened. Meta-analysis results showed that the initial screening positive rate was 14% [95%CI (11%-19%), P ＜ 0.0001]. The detection rate of colorectal lesions was 16% [95%CI (12%-19%), P ＜ 0.0001], and the early diagnosis rate was 93% [95%CI (92%-95%), P ＜ 0.0001]. The detection rate of colorectal cancer was 1% [95%CI (1%-2%), P ＜ 0.0001]. Stratified analysis of the detection rate of colorectal lesions found that: urban (17%) was higher than rural (8%), the South (15%) was slightly higher than the North (12%), the results of opportunistic colorectal cancer screening based on physical population (13%) were slightly lower than those of the natural community population (16%). Conclusion The questionnaire survey combined with the sequential screening method of fecal occult blood for colorectal cancer can increase the positive rate of initial screening, suitable for areas with poor compliance with colonoscopy.
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