An exploratory study of a new mode of opportunistic screening in first-degree relatives of patients with colorectal neoplasms

doi:10.3877/cma.j.issn.2095-3224.2022.02.008

Abstract

Abstract:

Objective

To explore the effectiveness of a new mode of screening in colorectal ward in first-degree relatives of patients with colorectal neoplasms.

Methods

Colorectal cancer risk questionnaire, fecal immunochemical test (FIT) and multitarget stool DNA testing were used to detect first-degree relatives of colorectal cancer and advanced adenoma patients treated at the Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from October 2019 to July 2021. Based on the test results, screening risk stratification for first-degree relatives and recommended colonoscopy classification were performed, and their colonoscopy compliance rate and lesion detection rate were analyzed.

Results

A total of 250 subjects were included in this study. The colonoscopy compliance rate of the overall population was 38.0% (95/250), and the detection rate of colonoscopy lesions was 9.5% (9/95); the colonoscopy compliance rate of category A recommended population was 78.9% (15/19), the lesion detection rate was 26.7% (4/15); the colonoscopy compliance rate of category B recommended population was 61.2% (30/49), and the lesion detection rate was 16.7% (5/30); the colonoscopy compliance rate of the category C recommended population was 27.5% (50/182), and the lesion detection rate was 0 (0/50).

Conclusion

The combined use of the three screening methods can efficiently and accurately distinguish the screening risk of first-degree relatives. This program is an effective and feasible ward-based mode of opportunistic screening in first-degree relatives of patients with colorectal neoplasms.

Key words: Colorectal neoplasms, First-degree relatives, Multitarget stool DNA testing, Opportunistic screening, Colonoscopy

Haiyang Huang, Xu Guan, Hongxia Nie, Hong Yun, Wenjuan Hu, Zhixun Zhao, Haipeng Chen, Zheng Liu, Zheng Jiang, Yinggang Chen, Xishan Wang. An exploratory study of a new mode of opportunistic screening in first-degree relatives of patients with colorectal neoplasms[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2022, 11(02): 141-148.

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Figures/Tables 8

References 26

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风险因素	得分
年龄（岁）
＜50	0
50~69	2
≥70	3
性别
女性	0
男性	1
家族史（一级亲属）
无	0
有	2
吸烟
绝不	0
现在或过去	1

风险因素	得分
年龄（岁）
＜50	0
50~69	2
≥70	3
性别
女性	0
男性	1
家族史（一级亲属）
无	0
有	2
吸烟
绝不	0
现在或过去	1

肠镜检查推荐分类	筛查风险分层	分类分层依据
A类推荐人群	高风险人群	APCS问卷评分、FIT、粪便多靶点FIT-DNA检测三项结果均为阳性，一级推荐行肠镜检查
B类推荐人群	中风险人群	APCS问卷评分结果阳性，FIT、粪便多靶点FIT-DNA检测其中一项结果为阳性，二级推荐行肠镜检查
C类推荐人群	低风险人群	APCS问卷评分结果阳性，FIT、粪便多靶点FIT-DNA检测两项结果均为阴性，三级推荐行肠镜检查

肠镜检查推荐分类	筛查风险分层	分类分层依据
A类推荐人群	高风险人群	APCS问卷评分、FIT、粪便多靶点FIT-DNA检测三项结果均为阳性，一级推荐行肠镜检查
B类推荐人群	中风险人群	APCS问卷评分结果阳性，FIT、粪便多靶点FIT-DNA检测其中一项结果为阳性，二级推荐行肠镜检查
C类推荐人群	低风险人群	APCS问卷评分结果阳性，FIT、粪便多靶点FIT-DNA检测两项结果均为阴性，三级推荐行肠镜检查

变量	A类推荐人群（n=19）	B类推荐人群（n=49）	C类推荐人群（n=182）	检验值	P值
年龄（岁）	46（40~52）	45（42~52.5）	45（41.8~52）	H=0.509	0.775
性别				χ²=3.363	0.186
男性	9（47.4）	27（55.1）	74（40.7）
女性	10（52.6）	22（44.9）	108（59.3）
APCS评分				H=3.054	0.217
2	6（31.6）	12（24.5）	69（37.9）
3	3（15.8）	11（22.4）	28（15.4）
4	6（31.6）	16（32.7）	64（35.2）
5	1（5.3）	2（4.1）	4（2.2）
6	3（15.8）	7（14.3）	17（9.3）
7	0	1（2.0）	0
FIT阳性	19（100）	38（77.6）	0	χ²=201.535	＜0.001
多靶点粪便DNA检测阳性	19（100）	11（22.4）	0	χ²=169.218	＜0.001
完成肠镜	15（78.9）	30（61.2）	50（27.5）	χ²=33.301	＜0.001
AN	4（26.7）	5（16.7）	0	χ²=13.182	=0.001
病理诊断
癌	0	1（3.3）	0
进展期腺瘤	4（26.7）	4（13.3）	0
非进展期腺瘤	2（13.3）	5（16.7）	4（8.0）
息肉或炎症	4（26.7）	11（36.7）	16（32.0）
正常	5（33.3）	9（30.0）	30（60.0）

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