Screening And Early Prevention For Asymptomatic Physical Examination People Colorectal Cancer Above50Years Old

Colorectal cancer is one of the most common human malignant tumors,its incidence ranks third in the global malignancy. For lack of clinicalspecificity, the early asymptomatic colorectal cancer often leads tomisdiagnosis,even delayed treatment,so that patients is already in middle-latelesions, thus improving the level of diagnosis and treatment of colorectalcancer, especially as to early diagnosis and treatment in time, should havegreat significance to improve patients survival rate and their life quality.Thecarrying out high-risk population census of colorectal cancer is an importantmethod to detect early colorectal cancer.In recent years, the colorectal cancer incidence in China shows anincreasing trend, and the mortality rate has been the fifth mortality causes inmalignant tumor, However, the colorectal cancer trend in Hebei province isnot yet clear.Therefore, it is necessary to conduct a survey on the incidence ofcolorectal cancer in our province, in order to start the program of preventionand cure earlier.In Foreign research,70%to75%of colorectal cancer patients come fromthe asymptomatic population over the age of50. If an asymptomaticpopulation over the age of50can regularly be screened, the incidence ofcolorectal cancer can be reduced by76%to90%and mortality can be reducedby60%.In this study, by colorectal cancer screening for asymptomatic peopleover the age of50, screening out of adenomatous polyps precancerouslesions and early cancer.Then carrying out endoscopic resection or surgicaltreatment to the people above,which will reduce colorectal cancer morbidity,mortality. Objective: Through colorectal cancer screening for asymptomatic peopleover the age of50, screening out of adenomatous polyps, precancerous lesionsand early cancer.Then carrying out endoscopic resection or surgical treatmentto the people above,which will reduce colorectal cancer morbidity, mortality,and mortality.Methods:1The application of questionnaires survey and hemoglobin/transferrincombined immune fecal occult blood in colorectal cancer screeningconducting a questionnaire survey and making fecal occult blood test forthe health medical employees who were over50years in the second affiliatedhospital of Hehei Medical Univercity from March2011to March2012.Thecontents of the questionnaire referred to the information Zheng Shu, to screenout high-risk groups of colorectal cancer. Using joint immunoassay fecaloccult blood test (colloidal gold double-test strip method) in order to screenout positive population.2The comparision of colorectal cancer and precancerous lesions in differentgroupsHigh-risk groups and people whose fecal occult blood test(FOBT)showedpositive were conducted colonoscopy, in which the positive material would beinsped and made histopathologic diagnosis of the pathology by WHOstandards. The proportion of colorectal cancer and precancerous lesions indifferent groups were accounted and described by/100,000. The comparisionof Rate with the chi-square test,p<0.05indicated significant difference.3The overall evaluation of colorectal cancer screening programThe sensitivity, specificity and likelihood ratio were used to evaluate themethods of questionnaires survey and FOBT program, the predictive valuewas used to evaluate the screening program. Significant compared with thechi-square test, p<0.05indicated significant difference.Results：1The application of questionnaires survey and hemoglobin/transferrincombined immune fecal occult blood in colorectal cancer screening Those people receiving questionnaires and the fecal occult blood test was22853，the number who were in the high-risk conditions was342，with thedetection rate was1.5%,and in which the number of immunoassay FOBTpositive was61,with the detection rate was17.8%; while the number ofasymptomatic high-risk groups was22511,and the number of immunologicalFOBT positive was963，with the detection rate was4.3%.2The comparision of colorectal cancer and precancerous lesions in differentgroupsThe number of high-risk group accepted colonoscopy was331,in which2cases of colorectal cancer were detected,The detectable rate was604.2／100.000,108cases of colorectal polyps were detected,The detectable rate was32.8%,the treatment rate was49.1%,63cases of ulcerative colitis weredetected,The detectable rate was19.0%;The number of positive of immunityFOBT accepted colonoscopy was989，in which3cases of colorectal cancerwere detected,The detectable rate was303.3／100．000,162cases of colorectalpolyps were detected,The detectable rate was16.4%,the treatment rate was48.%,159cases of ulcerative colitis were detected,The detectable rate was16.1%.3The overall evaluation of colorectal cancer screening programThe sensitivity of questionnaire survey was40.0%，and specificity98.5%,while in FOBT60.0%and95.5%,respectively.The Youden’s index of questionsurvey was0.39,FOBT0.56，independently．The positive likelihood ratio ofquestionnaire survey Was26.8， followed by FOBT13.4.The positivepredictive value in the positive of immunity FOBT was0.29%.while inhigh-risk group was0.58%．Conclusion:1The proportion of high-risk group of colorectal cancer in asymptomatichealthy people over the age of50was1.5%, whose immunity FOBT positiverate was17.8%,high-risk groups immune method of positive FOBT wassignificantly higher than no symptoms of high-risk groups.2Over the age of50asymptomatic healthy individuals，colorectal cancer detection rate was22.6/100000,at higher risk of bowel polyps detection ratewas significantly higher than the immune method of FOBT positive people.3The methods of questionnaires survey and FOBT program that having highsensitivity, specificity and positive likelihood ratio were suitable for colorectalcancer screening,they could find early colorectal cancer and precancerouslesions that were gotten cure in can cure stage,so as to reduce the incidence ofcolorectal cancer and mortality．...