Advance notification letters increase adherence in colorectal cancer screening: A population-based randomized trial
Advance notification letters increase adherence in colorectal cancer screening: A population-based randomized trial
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DOI：
10.1016/j.ypmed.2011.01.032
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发表时间：
2011-06-01
影响因子：
5.1
通讯作者：
Kuipers, Ernst J.
中科院分区：
文献类型：
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作者：
van Roan, A. H. C.;Hal, L.;Kuipers, Ernst J.
Objective.筛查的人群效益不仅取决于测试的有效性，还取决于坚持性，对于结直肠癌（CRC）筛查仍然很低。预先通知信可能会增加依从性，但是，没有基于人群的随机试验已经进行，以提供证据。2008年，对荷兰人口（50-74岁）的代表性样本进行了随机抽样。A组的所有2493名受邀者都收到了事先通知信，两周后又收到了标准邀请。B组的2507名受邀者只收到了标准邀请。两组中的非应答者在邀请后6周发送提醒。提前通知函导致依从性显著更高（64.4% vs 61.1%，p值0.019）。多变量logistic回归分析显示，组与年龄、性别或社会经济地位之间没有显著的相互作用。成本分析表明，由于发送预先通知函，每增加一个检测到的晚期肿瘤的增量成本为957。这项基于人群的随机试验表明，发送预先通知信可显著增加3.3%的依从性。每增加一个检测到的晚期肿瘤的增量成本是可以接受的。因此，我们建议将此类信函纳入标准的CRC筛选邀请程序。(C)2011 Elsevier Inc. All rights reserved.
Objective. The population benefit of screening depends not only on the effectiveness of the test, but also on adherence, which, for colorectal cancer (CRC) screening remains low. An advance notification letter may increase adherence, however, no population-based randomized trials have been conducted to provide evidence of this.Method. In 2008, a representative sample of the Dutch population (aged 50-74 years) was randomized. All 2493 invitees in group A were sent an advance notification letter, followed two weeks later by a standard invitation. The 2507 invitees in group B only received the standard invitation. Non-respondents in both groups were sent a reminder 6 weeks after the invitation.Results. The advance notification letters resulted in a significantly higher adherence (64.4% versus 61.1%, p-value 0.019). Multivariate logistic regression analysis showed no significant interactions between group and age, sex, or socio-economic status. Cost analysis showed that the incremental cost per additional detected advanced neoplasia due to sending an advance notification letter was (sic)957.Conclusion. This population-based randomized trial demonstrates that sending an advance notification letter significantly increases adherence by 3.3%. The incremental cost per additional detected advanced neoplasia is acceptable. We therefore recommend that such letters are incorporated within the standard CRC-screening invitation process. (C) 2011 Elsevier Inc. All rights reserved.