居民对结直肠癌新型粪便免疫化学检测筛查技术接受及评价情况的多中心调查

Population's acceptance and attitude toward a novel fecal immunochemical test for colorectal cancer screening:a multi‑center survey in China

目的了解居民对新型粪便免疫化学检测(FIT)技术的整体主观接受情况及对筛查流程不同环节的评价情况。方法于2018年5月至2019年5月,以5个省份(浙江、安徽、江苏、湖南和云南)为研究现场,招募2474名50~74岁人群为研究对象。通过问卷调查获得一般人口学特征、对FIT接受和评价情况及FIT筛查各环节遇到困难。采用多因素logistic回归模型分析取样、结果读取和结果上传过程所遇困难的相关因素。结果研究对象的年龄为(60.0±6.4)岁,女性、受教育程度为高中/中专及以上、无业人员/退休/其他、已婚、新型农村合作医疗者分别占61.7%(1526名)、29.0%(718名)、34.3%(849名)、92.7%(2293名)、31.3%(775名)。居民对FIT技术总体主观接受度为94.8%;取样、结果读取和上传环节遇到困难者分别占33.1%(819名)、46.4%(1147名)和62.9%(1557名);主要困难在不确定取样操作是否标准(28.0%)、无法准确判断结果显示(32.5%)以及不使用智能手机而需帮忙(44.2%)。多因素logistic回归模型分析结果显示,65~74岁、医保状况为新型农村合作医疗者在取样过程遇到困难的可能性较高,无业人员/退休/其他和共同生活家庭成员数大于在3人及以上者在取样过程遇到困难的可能性较低;65~74岁、农民或农民工、医保状况为新型农村合作医疗者在结果读取中遇到困难的可能性较高,共同生活家庭成员数在3人及以上者在结果读取中遇到困难的可能性较低;医保状况为新型农村合作医疗者在结果上传过程遇到困难的可能性较高,教育水平为高中/中专及以上、共同生活家庭成员数为3人及以上者在结果上传过程遇到困难的可能性较低。结论居民对新型FIT技术主观接受度较高;年龄、教育水平、职业、共同生活家庭成员数和医保状况可能与取样、结果读取和结果上传过程所遇困难有关联。

Objective To investigate the acceptance and attitude toward a novel fecal immunochemical test(FIT)in colorectal cancer screening among populations in China.Methods From May 2018 to May 2019,2474 people aged 50-74 years were recruited from five provinces of China(Zhejiang,Anhui,Jiangsu,Hunan and Yunnan).The general demographic characteristics,acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey.Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool,reading and uploading results.Results The subjects were(60.0±6.4)years old,and female,high school of above educated,unemployed/retired/other,married and with medical insurance status of"new rural cooperative medical care(NRCMC)"accounted for 61.7%(1526),29.0%(718),34.3%(849),92.7%(2293)and 31.3%(775),respectively.The population's acceptance of the FIT technology was 94.8%.In the process of FIT screening,the percentage of occurred difficulties in sampling stool,reading and uploading results were 33.1%(819),46.4%(1147)and 62.9%(1557),respectively.The main difficulties were the uncertainty about whether the sampling operation was standard(28.0%),the inability to accurately judge the result displayed(32.5%)and the need for help without using a smartphone(44.2%).The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of"NRCMC"were more likely to encounter difficulties in sampling,and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling.Those aged 65-74 years old,farmers or migrant workers,and those with"NRCMC"were more likely to encounter difficulties in readingresults,and those with 3 or more family members were less likely to encounter difficulties in reading result.Those with"NRCMC"were more likely to encounter difficulties in uploading results,and those with education level of high school or above,living with more than 3 family members were less likely to encounter difficulties in uploading results.Conclusion The acceptance of the new FIT technology is relatively high among the subjects.Age,education level,occupation,number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool,reading and uploading results,and it can be further strengthened in terms of the technology and characteristics of sub‑populations.