Key result
School scoliosis screening identified suspected cases in 9.76% of students, but only 57.9% complied with hospital referral, resulting in an estimated scoliosis prevalence of 1.9%.
Cross-Sectional (n=5,327)
School screening can detect adolescent scoliosis effectively, but low hospital referral compliance highlights the need for increased awareness among residents.
Low referral compliance may limit school screening yield; leaves open optimal strategies to improve adolescent follow-up.
Significant prevalence rates of adolescent scoliosis in China were suggested in previous studies. However, school screenings for adolescent scoliosis have been suspended due to low rates of positive detection under the past screening system in China. The present study was undertaken to screen for adolescent scoliosis in middle school students under a modern assessment system in a district of Shanghai. We performed a population-based, cross-sectional study of a middle school scoliosis screening program in the Jingan district. In 2015, schoolchildren were initially screened by visual inspection of clinical signs and the forward-bending test. Suspected cases were referred for radiography in hospital for scoliosis diagnosis. A total of 5327 middle school students (grades 6-8) were screened with 520 (9.76%) positives (the positive rates of girls and boys at 15.28% and 4.59%, respectively) and no statistically significant difference among grades. Only 301 positives (57.9%) followed the referral for hospital radiography. There were 102 cases (33.9%) that were diagnosed with scoliosis by radiography criteria (Cobb angle ≥10°) including mild scoliosis (Cobb 10-25) for 94 cases and moderate scoliosis (Cobb 25-40) for 8 cases, and false-positives (Cobb 0) for 39 cases. The putative prevalence rate was estimated as 1.9% from the referred students. Under an accurate and modern assessment system, school screenings can detect scoliosis at a significant rate, but awareness of scoliosis risks is needed for residents in China to take up referrals for hospital diagnosis after school screenings.
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Guo et al. (2017) conducted a cross-sectional in Adolescent scoliosis (n=5,327). School scoliosis screening (visual inspection and forward-bending test) was evaluated on Positive screening rate for suspected scoliosis. School scoliosis screening identified suspected cases in 9.76% of students, but only 57.9% complied with hospital referral, resulting in an estimated scoliosis prevalence of 1.9%.
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