Access to colorectal cancer screening in populations in China, 2020: A coverage‐focused synthesis analysis

Author:

Li Yan‐Jie1,Wang Xin1,Wu Yu‐Jie1,Zhou Xin‐Yi1,Li Jibin1,Qin Jiangmei2,Xu Wanghong3ORCID,Lew Jie‐Bin4ORCID,Chen Wanqing1ORCID,Shi Ju‐Fang1ORCID

Affiliation:

1. Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

2. Department of Health Development Strategy and Health Care System Research China National Health Development Research Centre Beijing China

3. Global Health Institute, School of Public Health, Fudan University Shanghai China

4. The Daffodil Centre The University of Sydney, a joint venture with Cancer Council New South Wales Sydney Australia

Abstract

AbstractIn populations in China, colorectal cancer (CRC) screening can be mainly accessed through organized screening, opportunistic screening, and physical examination. This screening intervention is found to be effective but the exact coverage rate is difficult to measure. Based on data from published articles, official websites, and available program reports, the screening coverage rate and related indicators were quantified. A rapid review was then conducted to estimate the overall and the breakdown coverage rates of the sub‐type screening services, by leveraging the numbers of articles and the by‐type median sample sizes. Up to 2020, two central government‐funded and four provincial/municipal‐level organized CRC screening programs have been initiated and included in this analysis. For populations aged 40–74, the estimated coverage rate of organized programs in China was 2.7% in 2020, and the 2‐year cumulative coverage rate in 2019–2020 was 5.3% and the 3‐year cumulative coverage rate in 2018–2020 was 7.7%. The corresponding coverage rates of 50–74‐year‐olds were estimated to be 3.4%, 7.1%, and 10.3%, respectively. Based on the rapid review approach, the overall screening coverage rate for 40–74 years, considering organized screening programs, opportunistic screening, and physical examinations, was then estimated to be 3.0% in China in 2020. However, comparing the findings of this study with the number of health check‐ups reported in the local national health statistics yearbooks suggests that the number of CRC physical examinations may be underestimated in this study. The findings suggest that further efforts are needed to improve population access to CRC screening in China. Furthermore, evidence for access to opportunistic CRC screening and physical examination is limited, and more quantitative investigation is needed.

Funder

National Natural Science Foundation of China

Publisher

Wiley

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