# Epidemiological survey of scoliosis screening in schools among 51,025 adolescents in Gannan Tibetan autonomous prefecture, Gansu Province, China

## TL;DR

A large-scale school-based screening found that 2.37% of 51,025 Tibetan and other ethnic adolescents in Gannan, China, showed signs of scoliosis, with higher rates in females and associations with age, BMI, and latitude.

## Contribution

This study provides the first comprehensive epidemiological data on suspected scoliosis in multi-ethnic adolescents in Gannan Tibetan Autonomous Prefecture using LASSO and logistic regression analyses.

## Key findings

- Suspected scoliosis prevalence was 2.37%, with 2.76% in females and 1.97% in males.
- Age, gender, BMI, and latitude were independently associated with suspected scoliosis.
- Most cases were mild (Grade I), with no significant variation in severity across spinal segments.

## Abstract

We completed a school suspected scoliosis screening (SSS) of multi-ethnic adolescents in Gannan Tibetan Autonomous Prefecture, Gansu Province, China, to examine the prevalence of suspected scoliosis in this area and associated risk factors.

From October 2024 to April 2025, we conducted scoliosis screening (SSS) in eight districts of the Gannan Tibetan Autonomous Prefecture: Zhaoni, Lintan, Luqu, Diebu, Zhouqu, Maqu, Xiahe, and Hezuo. Visual examination, the Adams forward bending test (FBT), and trunk rotation angle measurement were used to recognize suspected scoliosis. In this study, all screening-positive results are based on trunk rotation angle (ATR) ≥ 5, defined as “Suspected Scoliosis.” Demographic data were gathered, and the prevalence of suspected scoliosis was determined. The Least Absolute Shrinkage and Selection Operator (LASSO) regression technique was employed to identify characteristics most correlated with suspected scoliosis. The selected variables were further analyzed using multivariate logistic regression to ascertain the correlation between suspected scoliosis and the related factors.

A total of 67 schools and 51,025 adolescents (24,821 males and 26,204 females) attended screening. The total prevalence of suspected scoliosis among adolescents in the Gannan Tibetan Autonomous Prefecture was 2.37% (1,211 cases), with a prevalence of 2.76% in females, higher than the 1.97% seen in males (p < 0.01). LASSO regression analysis revealed a substantial association between age, height, weight, BMI, and latitude and suspected scoliosis. Following the exclusion of extraneous variables through LASSO regression, multivariate logistic regression analysis indicated that age (OR = 1.054, 95% CI: 1.027–1.082), gender (OR = 1.395, 95% CI: 1.241–1.567), BMI (OR = 0.950, 95% CI: 0.927–0.974), and latitude (OR = 0.611, 95% CI: 0.531–0.703) were independently correlated with suspected scoliosis. According to ATR, severity was categorized into three grades: Grade I suspected scoliosis in 832 cases (68.71%), Grade II suspected scoliosis in 296 instances (24.44%), and Grade III suspected scoliosis in 83 cases (6.83%). The thoracic segment, thoracolumbar segment, and lumbar segment comprised 25.85, 32.04, and 42.11%, respectively. No significant variations were seen in the distribution of suspected scoliosis severity across various segments.

The prevalence of suspected scoliosis among multi-ethnic students in Gannan Tibetan Autonomous Prefecture was 2.37%. Age, gender, BMI, and latitude were identified as factors influencing the prevalence.