ABSTRACT
Objective: To compare the detection rate of advanced neoplasia and the number of people needing endoscopy in colorectal cancer screening giving at different starting age in population at high risk. Methods: Based on the screening project of early diagnosis and treatment of colorectal cancer in Jiashan county, Zhejiang province, two rounds of colorectal cancer screening were conducted between January 2007 and December 2020. After excluding participants who were not at high risk or had incomplete information, 27 130 participants and 31 205 participants were finally enrolled in round one and in round two, respectively. The spline analysis based on the generalized additive model was used to describe the trend of detection rate of advanced neoplasia with age. The detection rate and number of people needing endoscopy for the groups with starting age at 50, 45 and 40 years were calculated, and the differences in the detection rate were tested by χ2 goodness of fit test. Results: A total of 21 077 (77.69%) participants in round one and 25 249 (80.91%) participants in round two received endoscopy, in whom 1 097 (detection rate=52.05) and 1 151 (detection rate=45.59) had advanced neoplasia (cancers and advanced adenomas), respectively. The detection rate increased significantly with age, and the detection rate in round one were significantly higher than that in round two (P<0.05). The overall detection rates of advanced neoplasia for the groups with starting age at 50, 45 and 40 years were 61.11, 56.14 and 52.05 in round one, and 49.10, 46.75 and 45.59 in round two, respectively. The rates were significantly higher for the group with starting age at 50 years than that with starting age at 40 years in both round one and round two (P<0.05). The numbers of people needing endoscopy of advanced neoplasia for the groups with starting age at 50, 45 and 40 years were 17, 18, and 20 in round one, and 21, 22 and 22 in round two. Conclusions: The detection rate of advanced neoplasia increased with age. Starting screening at lower age might contribute to decreased detection rate and increased number of people needing endoscopy. However, the difference was limited.
Subject(s)
Colorectal Neoplasms , Early Detection of Cancer , Adult , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Humans , Mass Screening , Middle Aged , Occult BloodABSTRACT
The research and application of heart sound (HS) analysis for cardiovascular disease (CVD) diagnosis has attracted more attention recently. Unlike other relevant HS analysis research, such as HS detection/component segmentation, HS feature extraction/classification etc., the proposed research treats HS as a whole and focuses mainly on comparing the similarity of acoustical characteristics reflecting pathological condition between two HSs, one of which is HS under test and another is the HS with known CVD. The concrete procedure refers to alignment of the HS into sequence and evaluating the similarity index through complexity and similarity analysis. In accordance with specific characteristics of HS, several relevant technologies such as musical instrument digital interface (MIDI), binary coding, N-gram, Lempel-Ziv (L-Z) complexity as well as super-symmetric comparison distance (SCD) similarity metric etc. are researched to be adapted and cascaded to realize the aforementioned target successfully. The contribution lies in that the aligning schemes including binary and N-gram are thoroughly investigated and then testing results witnessing the superiority of using N-gram in proposed approach are presented. The success of such a novel approach would not only assign a the new life to the traditional auscultation CVD diagnosis, but also simplify CVD diagnosis greatly leading to extensive application of such an efficient non-invasive physical diagnostic method in e-home healthcare.