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.
[1] Chen WQ，Zheng RS，Zhang SW，et al. Report of cancer incidence and mortality in China，2012 [J]. China Cancer，2016，25（1）：1-8.
[2] Guo C，Liu Q，Dai M. Colorectal cancer screening：situation and prospect [J]. Zhonghua Yu Fang Yi Xue Za Zhi，2015，49（5）：377-380.
[3] Zheng GM，Choi BC，Yu XR，et al. Mass screening for rectal neoplasm in Jiashan County，China [J]. J Clin Epidemiol，1991，44（12）：1379-1385.
[4] Rostom A，Dube C，Cranney A，et al. Celiac Disease- Appendix D. Quality Assessment Forms [M]. US：Agency for Healthcare Research and Quality，2004. sep. http：//www.ncbi.nlm.nih.gov/books/NBK35156/
[5] Dong ZW. Technical Proposal of Chinese Cancer Screening and Early Diagnosis [M]. Beijing：People′s Medical Publishing House，2009：123.
[6] Huang YQ，Cai SR，Zhang SZ，et al. Primary evaluation of a mass screening program for colorectal tumor in China [J]. Zhonghua Yu Fang Yi Xue Za Zhi，2011，45（7）：601-604.
[7] Zhang F，Wang WG，Xie Y，et al. Analysis on the influencing factors of compliance in colorectal cancer screening among residents in Songjiang District [J]. Zhejiang Prev Med，2015，27（1）：17-20.
[8] Li J，Li QL，Xue F，et al. Application of Feces Occult Blood Testing and Questionnaire Risk Assessment in Population Screening for Colorectal Cancer [J]. China Cancer，2015， 24（5）：385-389.
[9] Lou WP，Zhang L，Zhang W，et al. Analysis on the result of screening colorectal cancer in residents in communities of Fengxian District in Shanghai [J]. Chin J Prev Contr Chron Dis，2015，23（9）：657-660.
[10] Zhao LZ，Zhang WH，Ma DW，et al. Analysis of colorectal cancer screening result in Tianjing [J]. China Cancer Clinic，2015，42（15）：760-764.
[11] Pan X，Wang GZ，Fang DN，et al. colorectal screening in Xuhui district of shanghai from 2012 to 2013 [J]. Chin J Clinicians（Electronic Edition），2015，9（18）：3365-3368.
[12] Shen YZ，Huang YQ. Evaluation of colorectal cancer early detection screening program in Haining [J]. Chin J Prev Contr Chron Dis，2015，23（11）：836-838.
[13] Liu Y，Jiang YL，Gui P. Analysis on colorectal cancer screening result in Yinhang community of Shanghai in 2013 [J]. Chinese Primary Health Care，2014，28（6）： 71-73.
[14] Sun C，Liu SS，Cai BX，et al. Analysis on the result of colorectal cancer screening on natural population in community of Songhua district in Shanghai [J]. Chinese Primary Health Care，2014，28（7）：89-92.
[15] Zhu J，Liu CH，Zhao Y，et al. Colorectal cancer screening in Sujiatun district [J]. China Cancer，2014，23（9）：748-751.
[16] Mao XC，Xiang F，Xu XL，et al. Analysis of colorectal cancer screening results in west Qingpu district of Shanghai [J]. Health Education and Health Promotion，2015，10（5）：365-368.
[17] Xu F，Ying LY，Chen MT，et al. Analysis of opportunistic screening of colorectal cancer in Yongkang，Zhejiang Province [J]. China Cancer，2016，25（2）：96-98.
[18] Cai BX，Ji FM，Liu SS，et al. Analysis on the result of screening colorectal cancer in residents in communities of Songjiang district in Shanghai [J]. Health Education and Health Promotion，2016，11（1）：22-24.
[19] Zhang K，Zhai AJ，He BF，et al. Practice of colorectal screening in Yungang community of Beijing，2010-2011 [J]. Chin J Clinicians：Electronic Edition，2012，6（16）：4872-4873.
[20] Li F. Screening and early prevention for asymptomatic physical examination people colorectal cancer above 50 years old [D]. Shijiazhuang：Hebei Medical College，2012， 16-23.
[21] Han J，Wang JP，Zhang JL，et al. Analysis of colorectal screening results of Yingze district，Taiyuan [J]. Chinese Remedies and Clinics，2015，15（10）：1504-1506.
[22] Xu AG，Yu ZJ，Zhong XH，et al. Screening of high-risk group with colorectal cancer [J]. National Med J China，2010，90（2）：116-118.
[23] Zhang YY，Yuan PH，Yuan HF，et al. Jiading district community residents colorectal cancer screening results [J]. Medical Information，2015，28（5）：30.
[24] Wen M，Shan RC，Lun Z，et al. Performance value of high risk factors in colorectal cancer screening in China [J]. World Journal of Gastroenterology，2009，15（48）：6111-6116.
[25] Yu ZJ. Analysis on colorectal screening results and cost- effectiveness [D]. Guangdong：Guangdong Medical University，2006，45-50.
[26] Cai SR，Zheng S，Zhou L，et al. Practice of colorectal cancer screening on nature population in Hangzhou [J]. Journal of practical oncology，2006，21（2）：177-178.
[27] Zhao Y. Practice of colorectal cancer screening on nature population in Shanghai [D]. Shanghai：Fudan University，2009：34-36.
[28] Zhai AJ，Chen H，Wang GQ，et al. Cost - effectiveness of opportunistic screening for colorectal cancer in community population [J]. Chinese General Practice，2015，18（34）：4184-4186.
[29] Chen YM，Shi YL，Gu T. Analysis of colorectal cancer screening results of Chongming County [J]. Shandong Medical，2014，54（24）： 64-65.
[30] Yang F，Zhuang JM，He J，et al. Screening results analysis of colorectal cancer in Haicang district of Xiamen city [J]. J Mod Med Health，2013，29（20）：3076-3077.
[31] Gao MM，Gao XY. Analysis of colorectal cancer screening results of Jinfeng district，Yinchuan [J]. Ningxia Medical，2016，38（4）：378-379.
[32] Lu ZM，Chen JG，Zhang YX，et al. Preliminary report about the screening program for colorectal cancer by sequential fecal occult blood in Wuhan area for 4 years [J]. Chinese Journal of Gastrointestinal Surgery，2009，12（5）：474-476.
[33] Wang Q，Zhang YX，Chen JG. Preliminary report about the colorectal cancer screening in Wuhan City [J]. Colorectal Surgery，2012，18（3）：198-200.
[34] Lieborman D. Screening，surveillance，and prevention of colorectal cancer [J]. Gnstrointest Endosc Clin N Am，2008，18：595-605.
[35] Deng SX，Cai QC，An W，et al. Factors influencing patient compliance in colorectal cancer screening：qualitative research synthesis [J]. Zhonghua Yi Xue Za Zhi，2010，90（38）：2679-2673.
[36] National cancer center. Chinese cancer registry annual report [N].2012：56-59.
[37] Siegel RL，Miller KD，Jemal A. Cancer statistics，2017 [J]. CA：A Cancer Journal for Clinicians，2017，67（1）：7-30..
[38] Lin JS，Piper MA，Perdue LA，et al. Screening for Colorectal Cancer Updated Evidence Report and Systematic Review for the US Preventive Services Task Force [J]. JAMA，2016，315（23）：2576-2594.
[39] Shaukat A，Mongin SJ，Geisser MS，et al. Long-Term Mortality after Screening for Colorectal Cancer [J]. N Engl J Med，2013，369（12）：1106-1114.
[40] Scholefield JH，Moss S，Sufi F，et al. Effect of faecal occult blood screening on mortality from colorectal cancer： results from a randomised controlled trial [J]. Gut，2002，50（6）：840-844.
