Abstract: Objective To investigate the compliance of colonoscopy screening among high-risk colorectal cancer (CRC) populations in Nanjing and to analyze the factors influencing colonoscopy screening. Methods From January 2023 to January 2024, patients who visited the gastroenterology outpatient department of a tertiary hospital in Nanjing were enrolled and participated a quantified risk questionnaire survey about high-risk factors for colorectal cancer (CRC). Questionnaire evaluation results of the high-risk CRC population and their compliance with colonoscopy screening were analyzed. Factors influencing screening compliance were explored by using univariate and multivariate analysis. Results A total of 4 470 outpatients were enrolled in this study, among whom 1 098 were identified as having high-risk for colorectal cancer (CRC), with a detection rate of 24.56%. Of these high-risk individuals, 394 underwent colonoscopy screening, yielding a screening compliance rate of 35.88%. Multivariate logistic regression analysis revealed that higher education level (college degree or above, OR=2.101), average monthly household income≥4 000 RMB (OR=1.838), regular physical check-ups (OR=3.802), good family support (OR=1.636), direct relatives with a history of CRC (OR=2.599), personal history of malignancy (OR=5.924), history of intestinal polyps (OR=2.408), mucous bloody stool (OR=3.293), history of chronic biliary disease or cholecystectomy (OR=2.459), fear of invasive examinations (OR=0.421), complexity of screening preparation (OR=0.584), concern about post-screening risks (OR=0.495), embarrassment with the examination area (OR=0.611), and worry about adverse findings (OR=0.442) were significant factors influencing colonoscopy screening compliance among high-risk CRC individuals (P<0.05 or P<0.01). Conclusions The compliance with colonoscopy screening among high-risk CRC populations in Nanjing is relatively low. It is essential to provide appropriate guidance based on population characteristics and to strengthen publicity and education on cancer prevention and screening, in order to improve colonoscopy screening compliance among high-risk groups.

Key words: Colorectal cancer, High-risk population, Colonoscopy, Screening compliance