[The screening model for early diagnosis of colorectal cancer in general population]

In this study, 75,813 asymptomatic individuals above 30 in Jiashan County of Zhejiang Province were recruited in the screening program. Based on results of risk assessment using a mathematical model (expressed as AD value) and Reverse Passive Hemagglutination Fecal Occult Blood test (RPHA FOB). 62,667 subjects (82.7%) who completed two procedures were divided into 4 groups: 1) AD greater than or equal to 0.3 FOB (+) accounts for 1.2% of total; 2) AD less than 0.3 FOB (+) 3.0%; 3) AD greater than or equal to 0.3 FOB (-) 26.8%; 4) AD less than 0.3 FOB (-) 68.9%. Individuals in groups 1 and 2 were subjected to 60 cm fiberoptic colonoscopic examination; and those of group 3 with AD greater than or equal to 0.5 or with AD less than 0.5 but a positive repeated FOB test was also eligible for 60 cm colonoscopy. Out of 4,299 eligible subjects 3,162 were examined with 60 cm sigmoidoscopy (73.6%). 21 cases of colorectal cancer and 331 cases of polyps (including 75 adenomas) were detected. Among 21 cancers known of Dukes' stages 10 were at early stages (10 Dukes' A and 5 Dukes' B) accounting for 71.5%. According to the screening protocol individuals with negative 60 cm colonoscopic findings and consistently positive FOB results indicate that the lesion may be located above the spleen flexure and require a full fiberoptic colonoscopic examination (150 cm) and/or x-ray air-barium enema.