Evaluation of a Model for the Early Diagnosis of Colorectal Cancer by the Detection of 5-hydroxymethylcytosine (5-hmC) in Plasma Cell-free DNA to the Community Colorectal Cancer Screening Program

The incidence rate and mortality of colorectal cancer are increasing year by year. Most colorectal cancer develops from colorectal adenoma and is a disease that can be prevented and controlled. Thanks to early screening, the incidence rate and mortality of colorectal cancer have declined year by year. However, due to poor compliance with colonoscopy and the lack of efficient and convenient early screening methods, it is difficult to screen for colorectal cancer in China. According to the data from Shanghai Xuhui District Center for Disease Control and Prevention, the proportion of colonoscopies in high-risk groups for colorectal cancer is less than 18%.
This project plans to use the latest colorectal cancer screening technology, namely, 5hmC detection in peripheral blood and DNA methylation detection in feces, for those who are positive in the colorectal cancer incidence risk questionnaire or fecal occult blood in Xuhui District, Shanghai. It is strongly recommended that subjects with positive screening should undergo colonoscopy, to effectively improve the rate of colonoscopy and the early diagnosis rate of colorectal cancer. At the same time, to explore the screening efficiency of the early diagnosis model of 5hmC cancer.

结直肠癌（colorectal cancer）的发病率与死亡率呈逐年上升趋势。绝大多数结直肠癌由结直肠腺瘤进展而来，属于可防可控的疾病。通过早期筛查，结直肠癌的发病率与死亡率已实现逐年下降。但受限于结肠镜检查（colonoscopy）依从性不足，且缺乏高效便捷的早期筛查方案，我国结直肠癌筛查工作仍面临较大挑战。据上海市徐汇区疾病预防控制中心（Shanghai Xuhui District Center for Disease Control and Prevention）的统计数据，结直肠癌高危人群的结肠镜检查完成率不足18%。本项目拟采用当前最新的结直肠癌筛查技术——外周血5hmC检测（5hmC detection）与粪便DNA甲基化检测，针对上海市徐汇区结直肠癌发病风险问卷阳性或粪便隐血阳性的目标人群开展筛查。同时，强烈建议筛查结果呈阳性的受试者接受结肠镜检查，以切实提升结肠镜检查依从率与结直肠癌早期诊断率。此外，本项目还将探究5hmC癌症早期诊断模型的筛查效能。