Colorectal cancer screening uptake over three biennial invitation rounds in the English bowel cancer screening programme
Colorectal cancer screening uptake over three biennial invitation rounds in the English bowel cancer screening programme
复制标题
DOI：
10.1136/gutjnl-2013-306144
复制
发表时间：
2015-02-01
期刊：
影响因子：
24.5
通讯作者：
von Wagner, Christian
中科院分区：
文献类型：
--
作者：
Lo, Siu Hing;Halloran, Stephen;von Wagner, Christian
目的研究英国国家卫生服务体系（NHS）肠癌筛查计划（BCSP）两年三轮邀请中结直肠癌（CRC）筛查的模式。方法：我们分析了来自BCSP南部中心的数据，这些数据来自首次邀请筛查时年龄在60-64岁之间的个体（n=62 099），随访期间允许再进行两次两年一次的邀请。分析中使用了性别、年龄和社区社会经济剥夺程度的数据。结果包括采用愈创木粪便隐血（gFOB）试验筛查，gFOB筛查不充分（>= 1试剂盒）返回，但未能完成进一步的gFOB试验以获得结结性试验结果)，试验阳性，遵守随访检查（通常是结肠镜检查）和诊断结果。结果第一轮、第二轮和第三轮两年一次的gFOB总体上座率分别为57.4%、60.9%和66.2%。这导致70.1%的初始队列至少有一次反应，60.7%至少两次，44.4%三次。第一轮的参与对第二轮的参与具有很强的预测性（“以前的响应者”：86.6% vs“以前的无响应者”：23.1%）。在“一贯筛选者”中，第三轮的参与率最高（94.5%），其次是“后期进入者”（78.0%），“辍学者”（59.8%）和“一贯无反应者”（14.6%）。在三轮中观察到摄取方面的社会经济不平等，但性别不平等在几轮中有所减少。gFOB筛查不充分受筛查史和社会经济剥夺的影响。筛查史是随访依从性的唯一重要预测因子。结论：筛查史与gFOB的总体摄取、gFOB筛查不充分和随访依从性有关。社会经济剥夺也始终与gFOB摄取较低和gFOB筛查不充分有关。改善已确定的“高危”人群的定期筛查对CRC筛查规划的有效性非常重要。
Objective To examine patterns of colorectal cancer (CRC) screening uptake over three biennial invitation rounds in the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP) in England.Methods We analysed data from the BCSP's Southern Hub for individuals (n=62 099) aged 60-64 years at the time of first invitation to screening with a follow-up period that allowed for two further biennial invitations. Data on sex, age and a neighbourhood-level measure of socioeconomic deprivation were used in the analysis. Outcomes included uptake of guaiac-based faecal occult blood (gFOB) test screening, inadequate gFOB screening (>= 1 test kit(s) returned but failed to complete further gFOB tests needed to reach a conclusive test result), test positivity, compliance with follow-up examinations (usually colonoscopy) and diagnostic outcomes.Results Overall gFOB uptake was 57.4% in the first, 60.9% in the second and 66.2% in third biennial invitation round. This resulted in 70.1% of the initial cohort having responded at least once, 60.7% at least twice and 44.4% three times. Participation in the first round was strongly predictive of participation in the second round ('Previous Responders': 86.6% vs 'Previous Non-Responders': 23.1%). Participation in the third round was highest among 'Consistent Screeners' (94.5%), followed by 'Late Entrants' (78.0%), 'Dropouts' (59.8%) and 'Consistent Non-Responders' (14.6%). Socioeconomic inequalities in uptake were observed across the three rounds, but sex inequalities decreased over rounds. Inadequate gFOB screening was influenced by screening history and socioeconomic deprivation. Screening history was the only significant predictor of follow-up compliance.Conclusions Screening history is associated with overall gFOB uptake, inadequate gFOB screening and follow-up compliance. Socioeconomic deprivation is also consistently associated with lower gFOB uptake and inadequate gFOB screening. Improving regular screening among identified 'at-risk' groups is important for the effectiveness of CRC screening programmes.