Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020
Background and AimWith the increasing burden of colorectal cancer (CRC), the practice of colonoscopy is gaining attention worldwide. However, it exhibits distinct trends between developing and developed countries. This study aims to explore its development and identify influencing factors in China.M...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1276520/full |
| _version_ | 1797676918080798720 |
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| author | Yun-Fei Jiao Yun-Fei Jiao Zhi-Yuan Cheng Ye Gao Ye Gao Chu-Ting Yu Chu-Ting Yu Hui-Shan Jiang Hui-Shan Jiang Ting-Lu Wang Ting-Lu Wang Ying Deng Ying Deng Han Lin Han Lin Tian-Jiao Wang Tian-Jiao Wang Wei Wang Wei Wang Rong Wan Zhao-Shen Li Zhao-Shen Li Lei Xin Lei Xin Luo-Wei Wang Luo-Wei Wang |
| author_facet | Yun-Fei Jiao Yun-Fei Jiao Zhi-Yuan Cheng Ye Gao Ye Gao Chu-Ting Yu Chu-Ting Yu Hui-Shan Jiang Hui-Shan Jiang Ting-Lu Wang Ting-Lu Wang Ying Deng Ying Deng Han Lin Han Lin Tian-Jiao Wang Tian-Jiao Wang Wei Wang Wei Wang Rong Wan Zhao-Shen Li Zhao-Shen Li Lei Xin Lei Xin Luo-Wei Wang Luo-Wei Wang |
| author_sort | Yun-Fei Jiao |
| collection | DOAJ |
| description | Background and AimWith the increasing burden of colorectal cancer (CRC), the practice of colonoscopy is gaining attention worldwide. However, it exhibits distinct trends between developing and developed countries. This study aims to explore its development and identify influencing factors in China.MethodsThe Chinese Digestive Endoscopy Censuses were conducted twice in mainland China under the supervision of health authorities. Information regarding the practice of colonoscopy was collected through a structured online questionnaire. The authenticity of the data was evaluated through logical tests, and a random selection of endoscopic reports underwent manual validation by Quality Control Centers. Potential factors associated with colonoscopy were analyzed using real-world information.ResultsFrom 2012 to 2019, the number of hospitals that performed colonoscopy increased from 3,210 to 6,325 (1.97-fold), and the volume increased from 5.83 to 12.92 million (2.21-fold). The utilization rate rose from 436.0 to 914.8 per 100,000 inhabitants (2.10-fold). However, there was an exacerbation of regional inequality in the adequacy of colonoscopy. Regions with higher incidence of CRC, higher gross domestic product per capita, more average numbers of endoscopists and tertiary hospitals tended to provide more accessible colonoscopy (P<0.001). Nationwide, the cecal intubation rate improved from 83.9% to 94.4% and the unadjusted adenoma detection rate (ADR) improved from 16.3% to 18.1%. Overall, hospital grading, educational background of endoscopists, economic income, and colonoscopy volume were observed as the significantly positive factors affecting ADR (P<0.05), but not the incidence of CRC or the number of endoscopists.ConclusionsTremendous progress in colonoscopy has been made in China, but some issues needed timely reflection. Our findings provide timely evidence for better colonoscopy strategies and measures, such as quality control and medical education of endoscopists. |
| first_indexed | 2024-03-11T22:37:24Z |
| format | Article |
| id | doaj.art-ed8634af4fef477593fcb0737ca52236 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-11T22:37:24Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-ed8634af4fef477593fcb0737ca522362023-09-22T13:13:19ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-09-011310.3389/fonc.2023.12765201276520Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020Yun-Fei Jiao0Yun-Fei Jiao1Zhi-Yuan Cheng2Ye Gao3Ye Gao4Chu-Ting Yu5Chu-Ting Yu6Hui-Shan Jiang7Hui-Shan Jiang8Ting-Lu Wang9Ting-Lu Wang10Ying Deng11Ying Deng12Han Lin13Han Lin14Tian-Jiao Wang15Tian-Jiao Wang16Wei Wang17Wei Wang18Rong Wan19Zhao-Shen Li20Zhao-Shen Li21Lei Xin22Lei Xin23Luo-Wei Wang24Luo-Wei Wang25Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaDepartment of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, ChinaNational Digestive Endoscopy Improvement System, Shanghai, ChinaBackground and AimWith the increasing burden of colorectal cancer (CRC), the practice of colonoscopy is gaining attention worldwide. However, it exhibits distinct trends between developing and developed countries. This study aims to explore its development and identify influencing factors in China.MethodsThe Chinese Digestive Endoscopy Censuses were conducted twice in mainland China under the supervision of health authorities. Information regarding the practice of colonoscopy was collected through a structured online questionnaire. The authenticity of the data was evaluated through logical tests, and a random selection of endoscopic reports underwent manual validation by Quality Control Centers. Potential factors associated with colonoscopy were analyzed using real-world information.ResultsFrom 2012 to 2019, the number of hospitals that performed colonoscopy increased from 3,210 to 6,325 (1.97-fold), and the volume increased from 5.83 to 12.92 million (2.21-fold). The utilization rate rose from 436.0 to 914.8 per 100,000 inhabitants (2.10-fold). However, there was an exacerbation of regional inequality in the adequacy of colonoscopy. Regions with higher incidence of CRC, higher gross domestic product per capita, more average numbers of endoscopists and tertiary hospitals tended to provide more accessible colonoscopy (P<0.001). Nationwide, the cecal intubation rate improved from 83.9% to 94.4% and the unadjusted adenoma detection rate (ADR) improved from 16.3% to 18.1%. Overall, hospital grading, educational background of endoscopists, economic income, and colonoscopy volume were observed as the significantly positive factors affecting ADR (P<0.05), but not the incidence of CRC or the number of endoscopists.ConclusionsTremendous progress in colonoscopy has been made in China, but some issues needed timely reflection. Our findings provide timely evidence for better colonoscopy strategies and measures, such as quality control and medical education of endoscopists.https://www.frontiersin.org/articles/10.3389/fonc.2023.1276520/fullcolonoscopycolorectal canceradenoma detection ratececal intubation ratequality improvement |
| spellingShingle | Yun-Fei Jiao Yun-Fei Jiao Zhi-Yuan Cheng Ye Gao Ye Gao Chu-Ting Yu Chu-Ting Yu Hui-Shan Jiang Hui-Shan Jiang Ting-Lu Wang Ting-Lu Wang Ying Deng Ying Deng Han Lin Han Lin Tian-Jiao Wang Tian-Jiao Wang Wei Wang Wei Wang Rong Wan Zhao-Shen Li Zhao-Shen Li Lei Xin Lei Xin Luo-Wei Wang Luo-Wei Wang Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020 Frontiers in Oncology colonoscopy colorectal cancer adenoma detection rate cecal intubation rate quality improvement |
| title | Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020 |
| title_full | Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020 |
| title_fullStr | Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020 |
| title_full_unstemmed | Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020 |
| title_short | Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020 |
| title_sort | development quality and influencing factors of colonoscopy in china results from the national census in 2013 and 2020 |
| topic | colonoscopy colorectal cancer adenoma detection rate cecal intubation rate quality improvement |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1276520/full |
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