The prevention and treatment of colorectal cancer has become a societal concern. One key to colorectal cancer prevention and treatment is to improve the detection rate of colonoscopy screening, an essential tool for early diagnosis of colorectal cancer, in populations at high risk of colorectal cancer. Some research results show that the ability of individuals to make healthy choices and decisions is closely associated with their ability to acquire and understand information.

To investigate the association of health literacy level with colonoscopy screening compliance in an at-risk population identified by the first colorectal cancer screening.

Participants were individuals at risk of colorectal cancer selected from January to March 2020 who were identified by the general colorectal cancer screeningconducted by a community health center in Shanghai's Yangpu District during 2017—2018. General Demographic Information Questionnaire and the Chinese version of Health Literacy Management Scale (HeLMS-C) were used to conduct a questionnaire survey.

Altogether, 337 cases attended the survey, and 329 of them (97.6%) who handed in responsive questionnaires were finally included. Among the respondents, 252 had never received a colonoscopy, and only 77 had received that, with a colonoscopy screening compliance of 23.4%. The total average HeLMS-C score for the respondents was (103.77±3.78) . And the average scores of four domains of the scale, namely accessing GP healthcare services, communication with health professionals, patient attitudes towards their health, and social support were (44.50±1.70) , (36.34±2.10) , (15.83±2.01) and (7.09±1.37) , respectively. The distribution of marital status, type of risk for colorectal cancer identified by the first colorectal cancer screening, total score of the HeLMS-C, scores of accessing GP healthcare services, communication with health professionals and patient attitudes towards their health differed significantly between respondents who received a colonoscopy and those who did not (P<0.05) . Logistic regression analysis results showed that the type of marriage status, patient attitudes towards their health and communication with health professionals were associated with colonoscopy screening compliance (P<0.05) .

Having a spouse, higher patient attitudes towards their health, and higher level of communication with health professionals were associated with higher colonoscopy screening compliance in individuals at risk of colorectal cancer identified by the first colorectal cancer screening. In view of this, to improve the colonoscopy screening compliance of these people, attention should be paid to the improvement of the level of their health literacy.

近年来，大肠癌的防治引起了全社会的广泛重视。肠镜作为大肠癌早期诊断的必要手段，在大肠癌高危人群中提高其检查率是大肠癌防治工作的关键所在。研究表明，个人做健康选择与决策的能力与其获取并理解信息的能力密切相关。

探讨大肠癌初筛阳性人群健康素养水平对其肠镜检查依从性的影响。

2020年1—3月，选择上海市杨浦区某社区卫生服务中心2017—2018年普查中大肠癌初筛阳性人群作为调查对象。采用一般资料调查表、健康素养管理量表（HeLMS）对其进行调查。

共计发放问卷337份，回收有效问卷329份，问卷有效回收率为97.6%。329例大肠癌初筛阳性人群中，77例接受肠镜检查（接受肠镜组），252例未接受肠镜检查（拒绝肠镜组），肠镜检查依从率为23.4%。329例大肠癌初筛阳性人群HeLMS总平均得分为（103.77±3.78）分，信息获取能力、交流互动能力、改善健康意愿、经济支持意愿维度平均得分分别为（44.50±1.70）、（36.34±2.10）、（15.83±2.01）、（7.09±1.37）分。接受肠镜组和拒绝肠镜组大肠癌初筛阳性人群婚姻状况、初筛阳性类型、健康素养总分及信息获取能力、交流互动能力、改善健康意愿维度得分比较，差异有统计学意义（P<0.05）。Logistic回归分析结果显示，婚姻状况、改善健康意愿及交流互动能力维度得分是大肠癌初筛阳性人群肠镜检查依从性的影响因素（P<0.05）。

社区大肠癌初筛阳性人群中，有配偶的居民、改善健康意愿更强及交流互动能力更强的居民，肠镜检查依从性更高。提高大肠癌初筛阳性居民肠镜检查依从性，应注重对居民健康素养水平的培养。