Colorectal cancer epidemiology and prevention study in China


Colorectal cancer (CRC) is one of the most common causes of death from cancer in China. During the past twenty years, several case-control studies revealed the high risk factors of CRC in China, which were personal history of intestinal polyp, chronic diarrhea, feces with mucin and blood, psychic attack, drinking of unclear water, operation on appendix, history of chronic constipation and family history of cancer. From these factors, a risk-asessment mode (AD value) was constructed, combined with RPHA-FOB, a mass screening mode was established and applied into common people, awarded with a good result. The population-based CRC prevention including randomized trial has been conducted in two fields (Haining city and Jiashan city in Zhejiang province), which demonstrated that removal of CRC pre-cancer lesions such as adenomas and polyps could reduce CRC incidence and mortality remarkably.

This is a preview of subscription content, access via your institution.


  1. 1

    Li LD, Rao KQ, Zhang SW,et al. Statistical analysis of data from 12 cancer registries in China, 1973–1997. Bulletin Chinese Cancer, 2002, 9: 497–507.

    Google Scholar 

  2. 2

    Li LD, Lu FZ, Zhang SW. Analyses of variation trend and short-term detection of Chinese malignant tumor mortality during twenty years. Chinese J Oncol, 1997, 19: 3–9.

    CAS  Google Scholar 

  3. 3

    Whittemore AS, Wu-williams AH, Lee M,et al. Diet, physical activity and colorectal cancer among Chinese in North America and China. J Natl Cancer Inst, 1990, 82: 915–926.

    PubMed  Article  CAS  Google Scholar 

  4. 4

    Yang G, Gao YT, Ji BT,et al. Epidemiology study of nutrients and colorectal cancer. J Chin Epidemiol, 1994, 5: 299–302.

    Google Scholar 

  5. 5

    Zheng S, Zhou L, Yu H,et al. Colorectal cancer case-control study in six cities in China. Tumor, 1995, 2: 149–151.

    Google Scholar 

  6. 6

    Jiao DA, Shen GF, Shen YZ,et al. A case-control study of recteo-colon cancer. J Chin Epidemiol, 1985, 5: 285–288.

    Google Scholar 

  7. 7

    Jiao DA, Wu DR, Chen K,et al. A survey of risk factors of colorectal cancer in high-incidence area Jiashan county. J Chin Epidemiol, 1988, 9: 354–357.

    CAS  Google Scholar 

  8. 8

    Liu XY, Zhou L, Yu H,et al. A case-control study of 286 cases of colorectal cancer in Jiashan county. J Prev Treat Chroni Dis, 1994, 2: 122–123.

    Google Scholar 

  9. 9

    Yang G, Gao Y, Hu Y,et al. A study of genetic epidemiology on large howel cancer in Shanghai-I. Evaluation of segregation ratio and heritability. Chin J Med Gene, 1994, 11: 9–11.

    Google Scholar 

  10. 10

    Yang G, Zheng H, Yu H,et al. Environmental and genetic factors related to colorectal cancer. J Chin Epidemiol, 1992, 13: 30–33.

    CAS  Google Scholar 

  11. 11

    Yang G, Gao Y, Hu Y,et al. A study of genetic epidemiology on large bowel cancer in Shanghai-II. Evaluation of segregation ratio and heritability. Chin J Med Gene, 1994, 11: 89–91.

    Google Scholar 

  12. 12

    Liu J, Zheng S, Feng YZ,et al. Preliminary report on registration and family survey of familial adenomatous polyposis. Clin Oncology, 1997, 10: 756–759.

    Google Scholar 

  13. 13

    Chen K, Qiu JL, Zhang Y. Meta-analysis study on risk factors of colorectal cancer. J Zhejiang Univ (Med Sci), 2002, 4: 254–257.

    Google Scholar 

  14. 14

    Chen K. An applied study on the method of multi-factorial quantitative-risk assessment (MFQRA) for mass screening of colorectal cancer. Chinese J Oncol, 1993, 15: 37–40.

    CAS  Google Scholar 

  15. 15

    Chen K, Jiao DG, Zheng S,et al. Diagnostic value of fecal occult blood testing for screening colorectal cancer. China Natl J New Gastroenterol, 1997, 3: 166–168.

    Google Scholar 

  16. 16

    Zhu WX, Lin JJ. Reverse passive hemagglutination for detection of fecal occult blood. Chin Med J, 1988, 101: 519–522.

    PubMed  CAS  Google Scholar 

  17. 17

    Zheng S, Wu JM, Zhou RB,et al. Colorectal cancer mass screening protocal and its assessment. Chin Med J, 1991, 71: 381–384.

    CAS  Google Scholar 

  18. 18

    Zhou L, Yu H, Zheng S. The verification of optimized protocol for colorectal cancer in general population of high-incidence area. J Prev Treat Chroni Dis, 1997, 5: 75–76.

    Google Scholar 

  19. 19

    Liu XY, Zheng S, Yang G,et al. Application of optimized protocol of colorectal cancer in high risk population. Cancer Research Prevention & Treatment, 1997, 24: 197–199.

    Google Scholar 

  20. 20

    Zheng S, Liu XY, Ding KF,et al. Reduction of the incidence and mortality of the rectal cancer by polypectomy: a prospective cohort study in Haining county. World J Gastroenterol, 2002, 3: 488–492.

    Google Scholar 

  21. 21

    Liu XY, Zheng S, Chun K,et al. Randomized controlled trial of sequence mass screening program for colorectal cance. J Chin Epidemiol, 2000, 6: 430–433.

    Google Scholar 

  22. 22

    Zheng S, Chen K, Liu XY,et al. Cluster randomization trial of sequence mass screening for colorectal cancer. Disease Colon & Rectum, 2003, 46: 51–58.

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Zheng Shu.

Additional information

This project was supported by grants from foundations of National “Seventh-five” (No. 75-61-02-17), “Eighth-five” (No. 85-914-01-09) key projects and Ministry of public Health of China (No. 981335).

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Shu, Z., Shanrong, C. Colorectal cancer epidemiology and prevention study in China. Chin. -Ger. J. Clin. Oncol. 2, 72–75 (2003).

Download citation

Key words

  • colorectal cancer
  • epidemiology
  • mass screening
  • risk factors
  • prevention