Evaluation Of The Application Of Self-reported Symptom Questionnaire In Colorectal Cancer Screening

Objective:By analyzing the colorectal cancer screening project carried out in Tianjin from 2012 to 2017,this study evaluated the early screening effect of the self-reported symptom questionnaire and its diagnostic value for advanced adenoma,colorectal cancer and other intestinal diseases.At the same time,through the cost-effectiveness analysis of the colorectal cancer screening project in Tianjin,the screening effects in different situations were compared in order to increase the screening effect and provide reference for optimizing the colorectal cancer screening programMethods:The self-reported symptom questionnaire and immune colloidal gold fecal occult blood test(FIT)were used to identify the high-risk population in the screening project of colorectal cancer in Tianjin,and the colonoscopy diagnosis was made for the high-risk population after re-screening.The purpose of this study was to evaluate the contribution of the questionnaire in screening by comparing the detection rate and early diagnosis rate of advanced adenoma,colorectal cancer and other intestinal lesions between positive result and negative result in self-reported symptom questionnaire combined with the pathological diagnosis results of colonoscopy and preliminary screening results.According to the survival data and treatment cost data of colorectal cancer patients provided by Tianjin People’s Hospital,we use Microsoft Excel@risk software to estimate the treatment costs of colorectal cancer patients in different situations,and get the cost and effectiveness in different scenarios.The single detection cost of intestinal lesions and the incremental cost-effectiveness ratio were used as indicators to evaluate the colorectal cancer screening project in TianjinResults:1.Overall,143,794(3.5%)individuals out of 4,152,168 participants reported positive results were considered as SRSQ(+)population.The CRC detection rate was 17 times in SRSQ(+)population(331 per 100,000)compared with that in SRSQ(-)population(19 per 100,000).The AA detection rate was 25 times in SRSQ(+)population(1119 per 100,000)compared with that in SRSQ(-)population(45 per 100,000).The early detection rate(EDR)was higher in SRSQ(+)than that of SRSQ(-)population(risk ratio 1.05,95%CI 1.02-1.08).Without SRSQ,29.4%(363 of 1236)CRC and 40.3%(1378 of 3422)AA would be missed2.In the screening project of colorectal cancer in Tianjin,the detection costs of single high-risk population,advanced adenoma and colorectal cancer were 339 yuan,19,654 yuan and 54,266 yuan respectively.Through screening,172 cases of potential colorectal cancer can be avoided,and the incremental cost-effectiveness ratio is 2.49 Compared with unscreened,the screening strategy with SRSQ can avoid the occurrence of potential colorectal cancer with an incremental cost-effectiveness ratio of 24900 yuan per year,and compared with the screening strategy without SRSQ,it costs 153000 yuan for each additional case of colorectal cancer detectedConclusion:SRSQ is an effective screening method to expedite the diagnosis of symptomatic CRC.It played an important role to reduce the misdiagnosed FIT colorectal neoplasia in current CRC screening program.