Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers - Systematic reviews of provider assessment and feedback and provider incentives
Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers - Systematic reviews of provider assessment and feedback and provider incentives
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DOI：
10.1016/j.amepre.2008.04.008
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发表时间：
2008-07-01
影响因子：
5.5
通讯作者：
Chattopadhyay, Sajal
中科院分区：
文献类型：
--
作者：
Sabatino, Susan A.;Habarta, Nancy;Chattopadhyay, Sajal
大多数主要的医疗机构建议对乳腺癌、宫颈癌和结直肠癌进行常规筛查。筛查可导致这些癌症的早期发现，从而降低死亡率。然而，并非所有应该接受筛查的人都接受了筛查，要么定期接受，要么在某些情况下从不接受。本报告介绍了对两种由提供者指导的干预方法的有效性、适用性、经济效率、实施障碍和其他危害或益处的系统评价结果，以增加乳腺癌、宫颈癌和结直肠癌的筛查。这些方法、提供者评估和反馈以及提供者奖励鼓励提供者在适当的时间间隔提供筛查服务。这些综述中的证据表明，提供者评估和反馈干预可以有效地增加乳房x光检查、巴氏涂片检查和粪便潜血检查的筛查。卫生计划、卫生保健系统和癌症控制联盟在实施增加筛查使用的干预措施时应考虑这些基于证据的发现。证据不足以确定提供者奖励措施在增加使用任何这些测试方面的有效性。本报告提出了进一步研究的具体领域，包括需要进行进一步研究，以确定提供者的奖励措施是否有效地增加了这些筛查试验中的任何一种的使用，以及评估和反馈干预措施是否有效地增加了结直肠癌的其他检查（即乙状结肠镜检查、结肠镜检查或双对比钡灌肠）。
Most major medical organizations recommend routine screening for breast, cervical, and colorectal cancers. Screening can lead to early detection of these cancers, resulting in reduced mortality. Yet not all people who should be screened are screened, either regularly or, in some cases, ever. This report presents results of systematic reviews of effectiveness, applicability, economic efficiency, barriers to implementation, and other harms or benefits of two provider-directed intervention approaches to increase screening for breast, cervical, and colorectal cancers. These approaches, provider assessment and feedback, and provider incentives encourage providers to deliver screening services at appropriate intervals. Evidence in these reviews indicates that provider assessment and feedback interventions can effectively increase screening by mammography, Pap test, and fecal occult blood test. Health plans, healthcare systems, and cancer control coalitions should consider such evidence-based findings when implementing interventions to increase screening use. Evidence was insufficient to determine the effectiveness of provider incentives in increasing use of any of these tests. Specific areas for further research are Suggested in this report, including the need for additional research to determine whether provider incentives are effective in increasing use of any of these screening tests, and whether assessment and feedback interventions are effective in increasing other tests for colorectal cancer (i.e., flexible sigmoidoscopy, colonoscopy, or double-contrast barium enema).