| [Objective] To analyze the correspondence between different combinations of primary screening results and colonoscopy outcomes in colorectal cancer (CRC) screening program among community residents in Jing "an District, Shanghai, from 2013 to 2021, and to clarify the classification of high-risk populations, so as to provide scientific basis for differentiated intervention strategies. [Methods] Screening data were derived from the database of CRC Screening Program in Jing "an District. Positive results of primary screening were divided into five combinations based on the results of the risk assessment questionnaire combined with two rounds of fecal occult blood tests (FOBT). Colonoscopy outcomes, considered as the gold standard, were categorized as non-precancerous lesions, precancerous lesions, and CRC. Multinomial logistic regression and correspondence analysis were used to assess the association between screening group and lesion risk. Multinomial logistic regression and correspondence analysis were used to assess the association between screening combinations and lesion risk. The "questionnaire-negative & double FOBT-positive" and "questionnaire-positive & double FOBT-positive" groups had the highest risks for CRC (OR=7.512 and 6.167, respectively) and precancerous lesions (OR=2.315 and 2.619, respectively). Correspondence analysis demonstrated a significant correspondence between screening groups and colonoscopy outcomes (all P<0.05), with the double FOBT-positive groups corresponding to the populations at the highest risk of colorectal cancer and precancerous lesions. [Conclusion] There is a clear risk gradient between combined primary screening results and colonoscopy outcomes. Individuals with double FOBT-positive results should be classified as extremely high-risk group, and differentiated intervention strategies based on risk levels are recommended to improve colonoscopy adherence and screening efficiency. |
