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©The Author(s) 2024.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2270-2280
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2270
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2270
Table 1 Comparison of baseline data among 19373 subjects, n (%)
| Index | Colonoscopy group (n = 3883) | FIT group (n = 7793) | Graded screening group (n = 7697) | P value |
| Gender | 0.172 | |||
| Male | 1617 (41.6) | 310 (42.5) | 3155 (41.0) | |
| Female | 2266 (58.4) | 4483 (57.5) | 4542 (99.0) | |
| Age (years) | 0.545 | |||
| 50-54 | 906 (23.3) | 1825 (23.4) | 1836 (23.9) | |
| 55-59 | 830 (21.4) | 1605 (20.6) | 1574 (20.4) | |
| 60-64 | 992 (25.5) | 1924 (24.7) | 1886 (24.5) | |
| 65-69 | 807 (20.8) | 1729 (22.2) | 1658 (21.5) | |
| 70-74 | 348 (9.0) | 712 (9.1) | 743 (9.7) | |
| Educational background | 0.614 | |||
| Junior high school and below | 2701 (73.4) | 5605 (72.2) | 5595 (72.9) | |
| High school | 696 (18.0) | 542 (19.9) | 1495 (19.5) | |
| University and above | 281 (7.6) | 621 (8.0) | 582 (7.6) | |
| Body mass index (kg/m²) | 0.614 | |||
| < 23 | 1395 (37.9) | 2872 (37.01) | 2860 (37.3) | |
| ≥ 23 | 2283 (62.1) | 4896 (63.0) | 4812 (62.7) | |
| Smoking | 646 | |||
| Non-smoking | 2978 (81.0) | 6269 (80.7) | 6154 (80.2) | |
| Quit smoking | 572 (15.6) | 1217 (15.7) | 1212 (15.8) | |
| Smoking | 28 (3.5) | 282 (3.6) | 306 (4.0) | |
| Drinking | 0.168 | |||
| Never | 2659 (72.3) | 5722 (73.7) | 5649 (73.6) | |
| Occasionally | 491 (13.3) | 047 (13.5) | 983 (12.8) | |
| Law | 528 (14.4) | 999 (12.9) | 1040 (13.6) | |
| Family history of colorectal cancer among first-degree relatives | < 0.001 | |||
| Yes | 60 (4.4) | 335 (4.3) | 473 (6.2) | |
| No | 3427 (93.2) | 7277 (93.7) | 7018 (91.7) | |
| Unclear | 91 (2.5) | 156 (2.0) | 161 (2.1) |
Table 2 Comparison of fecal occult blood test positivity rate and colonoscopy compliance rate between fecal occult blood test group and graded screening group
| Screening plan | Baseline screening | First follow-up screening | Second follow-up screening | |||
| FIT positivity rate | Colonoscopy compliance rate | FIT positivity rate | Colonoscopy compliance rate | FIT positivity rate | Colonoscopy compliance rate | |
| FIT group | 13.7 (1071/7793) | 76.3 (817/1071) | 5.6 (341/6048) | 75.7 (258/341) | 5.5 (339/6113) | 71.7 (2431339) |
| Graded screening group (Low-risk) | 10.2 (782/7697) | 76.9 (601/782) | 3.8 (244/6352) | 74.6 (182/244) | 2.7 (163/6131) | 0.1 (98/163) |
Table 3 Comparison of detection rates of advanced tumors
| Screening stage | Progressive tumors (%, 95%CI) | Colonoscopy group/FIT group | |||
| Colonoscopy group | FIT group | Graded screening group | OR (95%CI) | P value | |
| Baseline screening | |||||
| Overall | 2.76 (2.29-3.32) | 0.15 (0.94-1.42) | 0.65 (1.39-1.96) | 2.45 (1.84-3.26) | < 0.001 |
| Proximal colon | 1.36 (1.05-1.78) | 0.53(0.39-0.71) | 0.62 (0.47-0.83) | 2.62 (1.74-3.97) | < 0.001 |
| Distal colon and rectum | 1.73 (1.36-2.19) | 0.80 (0.62-1.02) | 0.17 (0.95-1.43) | 2.19 (1.54-3.12) | < 0.001 |
| Baseline screening + 1st follow-up screening | |||||
| Overall | 2.76 (2.29-3.32) | 0.67 (1.41-1.98) | 0.91 (1.63-2.24 | 1.68 (1.29-2.18) | < 0.001 |
| Proximal colon | 1.36 (1.05-1.78) | 0.72 (0.55-0.95) | 0.73 (0.56-0.94) | 1.91 (1.30-2.79) | 0.001 |
| Distal colon and rectum | 1.73 (1.36-2.19) | 1.15 (0.94-1.42 | 1.35 (1.12-1.63) | 0.50 (1.08-2.06) | 0.014 |
| Baseline screening + 1st follow-up screening + 2nd follow-up screening | |||||
| Overall | 2.76 (2.29-3.32) | 2.17 (1.87-2.52) | 2.35 (2.04-2.71) | 0.30 (1.01-1.65) | 0.037 |
| Proximal colon | 1.36 (1.05-1.78) | 0.96 (0.77-1.20) | 0.90 (0.71-1.13) | 1.46 (1.05-2.05) | 0.031 |
| Distal colon and rectum | 1.76 (1.45-2.18) | 1.48 (1.23-1.77) | 1.65 (1.39-1.96) | 1.19 (0.88-1.61) | 0.244 |
| Screening stage | Colonoscopy group compared to grading screening group | Graded screening group/FIT group | |||
| OR (95%CI) | P value | OR (95%CI) | P value | ||
| Baseline screening | |||||
| Overall | 1.69 (1.29-2.20) | < 0.001 | 1.45 (1.11-1.92) | 0.008 | |
| Proximal colon | 2.21 (1.49-3.28) | 0.001 | 1.19 (0.79-1.82) | 0.409 | |
| Distal colon and rectum | 1.46 (1.06-2.02) | 0.021 | 1.49 (1.08-2.08) | 0.017 | |
| Baseline screening + 1st follow-up screening | |||||
| Overall | 1.45 (1.12-1.87) | 0.004 | 1.15 (0.91-1.47) | 0.245 | |
| Proximal colon | 1.9 (1.29-2.76) | 0.001 | 1.01 (0.70-1.47) | 0.941 | |
| Distal colon and rectum | 1.26 (0.92-1.72) | 0.148 | 1.18 (0.88-1.57) | 0.266 | |
| Baseline screening + 1st follow-up screening + 2nd follow-up screening | |||||
| Overall | 1.19 (0.93-1.51) | 0.156 | 1.09 (0.88-1.34) | 0.440 | |
| Proximal colon | 1.56 (1.10-2.20) | 0.012 | 0.94 (0.68-1.29) | 0.681 | |
| Distal colon and rectum | 1.06 (0.79-1.42) | 0.680 | 1.12 (0.87-1.44) | 0.384 | |
Table 4 Comparison of colonoscopy load for detecting advanced tumors
| Screening phase | Advanced tumors (n, 95%CI) | ||
| Colonoscopy group | FIT group | Graded screening group | |
| Baseline screening | |||
| Overall | 15.4 (12.8-18.5) | 9.1 (7.5-11.1) | 10.3 (8.8-12.2) |
| Male | 10.7 (8.5-13.5) | 6.5 (5.2-8.3) | 8.0 (6.7-9.5) |
| Female | 22.9 (17.0-30.9) | 14.7 (10.4-21.1) | 22.4 (14.9-34.0) |
| Baseline screening + 1st follow-up screening | |||
| Overall | 15.4 (12.8-18.5) | 8.3 (7.1-9.7) | 10.5 (9.0-12.2) |
| Male | 10.7 (8.5-13.5) | 6.2 (5.1-7.5) | 8.2 (6.9-9.8) |
| Female | 22.9 (17.0-30.9) | 12.5 (9.4-16.7) | 18.6 (13.4-26.1) |
| Baseline screening + 1st follow-up screening + 2nd follow-up screening | |||
| Overall | 15.4 (12.8-18.5) | 7.8 (6.8-9.0) | 10.2 (8.9-11.8) |
| Male | 10.7 (8.5-13.5) | 5.9 (5.0-7.0) | 8.3 (7.1-9.8) |
| Female | 22.9 (17.0-30.9) | 11.4 (8.9-14.5) | 15.3 (11.8-20.1) |
Table 5 Comparison of colonoscopy load in random colorectal tumors
| Screening phase | Random colorectal tumors (n, 95%CI) | ||
| Colonoscopy group | FIT group | Graded screening group | |
| Baseline screening | |||
| Overall | 4.1 (3.8-4.5) | 3.2 (2.9-3.5) | 3.5 (3.2-3.8) |
| Male | 3.0 (2.7-3.4) | 2.5 (2.2-2.8) | 2.8 (2.6-3.1) |
| Female | 5.6 (4.9-6.4) | 4.5 (3.8-5.4) | 5.9 (4.9-7.3) |
| Baseline screening + 1st follow-up screening | |||
| Overall | 4.1 (3.8-4.5) | 3.1 (2.9-3.4) | 3.4 (3.2-3.7) |
| Male | 3.0 (2.7-3.4) | 2.5 (2.3-2.8) | 2.9 (2.6-3.1) |
| Female | 5.6 (4.9-6.4) | 4.2 (3.6-4.9) | 5.1 (4.3-6.0) |
| Baseline screening + 1st follow-up screening + 2nd follow-up screening | |||
| Overall | 4.1 (3.8-4.5) | 3.0 (2.8-3.3) | 3.5 (3.2-3.7) |
| Male | 3.0 (2.7-3.4) | 2.5 (2.3-2.7) | 2.9 (2.7-3.1) |
| Female | 5.6 (4.9-6.4) | 3.9 (3.5-4.5) | 4.9 (4.3-5.6) |
- Citation: Xu M, Yang JY, Meng T. Effectiveness of colonoscopy, immune fecal occult blood testing, and risk-graded screening strategies in colorectal cancer screening. World J Gastrointest Surg 2024; 16(7): 2270-2280
- URL: https://www.wjgnet.com/1948-9366/full/v16/i7/2270.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v16.i7.2270