An exploratory study of a new mode of opportunistic screening in spouses of patients with colorectal neoplasms

doi:10.3877/cma.j.issn.2095-3224.2022.03.008

Abstract

Abstract:

Objective

To explore the effectiveness of a new mode of screening in colorectal ward in spouses of patients with colorectal neoplasms.

Methods

Colorectal cancer risk questionnaire, fecal occult blood test and multitarget stool FIT-DNA testing were used to detect spouses 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, the spouses' screening risks and colonoscopy recommendations were divided into four categories: A, B, C, and D, and the spouses' colonoscopy compliance rate and lesion detection rate were analyzed.

Results

A total of 206 subjects were included in this study. The colonoscopy compliance rate of the overall population was 29.6% (61/206), and the lesion detection rate was 9.8% (6/61). The colonoscopy compliance rates of the recommended groups from category A to category D were 90.9% (10/11), 53.5% (23/43), 20.5% (23/112) and 12.5% (5/40), respectively. The lesion detection rates were 30.0% (3/10), 8.7% (2/23), 4.3% (1/23) and 0 (0/5), respectively.

Conclusion

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

Key words: Colorectal neoplasms, Spouses, Multitarget stool FIT-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 spouses of patients with colorectal neoplasms[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2022, 11(03): 232-240.

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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、FIT、粪便多靶点FIT-DNA检测有两项结果为阳性，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、FIT、粪便多靶点FIT-DNA检测有一项结果为阳性，三级推荐行肠镜检查
D类推荐人群	极低风险人群	APCS问卷评分、FIT、粪便多靶点FIT-DNA检测三项结果均为阴性，四级推荐行肠镜检查

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、FIT、粪便多靶点FIT-DNA检测有两项结果为阳性，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、FIT、粪便多靶点FIT-DNA检测有一项结果为阳性，三级推荐行肠镜检查
D类推荐人群	极低风险人群	APCS问卷评分、FIT、粪便多靶点FIT-DNA检测三项结果均为阴性，四级推荐行肠镜检查

变量	A类推荐人群（n=11）	B类推荐人群（n=43）	C类推荐人群（n=112）	D类推荐人群（n=40）	检验值	P值
年龄（岁）	54（52~70）	58（53~63）	59（54~64）	45（42~47.8）	H=81.226	＜0.001
年龄分组					χ²=123.708	＜0.001
40~49岁	1（9.1）	5（11.6）	13（11.6）	40（100）
50~74岁	10（90.9）	38（88.4）	99（88.4）	0
性别					χ²=2.105	0.551
男性	4（36.4）	14（32.6）	31（27.7）	8（20.0）
女性	7（63.6）	29（67.4）	81（72.3）	32（80.0）
APCS分组					χ²=157.712	＜0.001
0~1分（低风险）	0	4（9.3）	6（5.4）	40（100）
2~3分（中风险）	6（54.5）	28（65.1）	78（69.6）	0
4~7分（高风险）	5（45.5）	11（25.6）	28（25）	0
APCS阳性	11（100）	39（90.7）	106（94.6）	0	χ²=155.368	＜0.001
FIT阳性	11（100）	32（74.4）	6（5.4）	0	χ²=129.520	＜0.001
粪便多靶点FIT-DNA检测阳性	11（100）	15（34.9）	0	0	χ²=117.434	＜0.001
婚龄（岁）	33（24~45）	35（27~40）	34.5（30~40）	20（16.3~23）	H=63.776	＜0.001
婚龄分组（年）					χ²=71.053	＜0.001
15~29	4（36.4）	11（25.6）	27（24.1）	39（97.5）
≥30	7（63.6）	32（74.4）	85（75.9）	1（2.5）
完成肠镜	10（90.9）	23（53.5）	23（20.5）	5（12.5）	χ²=41.636	＜0.001
AN	3（30.0）	2（8.7）	1（4.3）	0	χ²=4.434	0.187
病理诊断
癌	0	1（4.3）	0	0
进展期腺瘤	3（30.0）	1（4.3）	1（4.3）	0
非进展期腺瘤	0	3（13.0）	2（8.7）	1（20.0）
息肉或炎症	2（20.0）	6（26.1）	6（26.1）	3（60.0）
正常	5（50.0）	12（52.2）	14（60.9）	1（20.0）

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