Methods to increase participation in organised screening programs: a systematic review.

Methods to increase participation in organised screening programs: a systematic review.
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DOI:
10.1186/1471-2458-13-464
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发表时间:
2013-05-13
期刊:
影响因子:
4.5
通讯作者:
Methods to increase participation Working Group
Methods to increase participation Working Group
中科院分区:
医学2区
文献类型:
--
作者:
Camilloni L;Ferroni E;Cendales BJ;Pezzarossi A;Furnari G;Borgia P;Guasticchi G;Giorgi Rossi P;Methods to increase participation Working Group

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欧洲共同体建议实施以人口为基础的宫颈癌、乳腺癌和结肠直肠癌筛查方案。这一建议得到了许多观察性研究的支持,这些研究表明,有组织的方案有效地降低了死亡率,并控制了筛查试验的不当使用。我们对评估干预措施有效性的研究进行了系统回顾,以增加有组织的基于人群的筛查计划的参与。我们纳入了1999年1月至2012年7月期间发表的所有旨在提高筛查参与率的干预研究。对于1999年之前发表的文献,我们考虑了Jepson等人(2000)的综述(Health Technol Assess 4:1-133,2000)。包括Jepson综述的研究,我们发现69项有组织筛查干预措施的定量信息:19项宫颈癌,26项乳腺癌,20项结直肠癌,4项宫颈癌和乳腺癌。有效的干预措施包括:邮政(乳腺RR = 1.37 95%置信区间(95% CI):1.25-1.51;宫颈RR = 1.71 95% CI:1.60-1.83;结直肠RR = 1.33 95% CI:1.17-1.51)和电话提醒(实施方式不同);邀请函上GP签名(乳腺RR = 1.13 95% CI:1.11-1.16;宫颈RR = 1.20 95% CI:1.10-1.30;结直肠RR = 1.15 95% CI:1.07-1.24);预约而非开放预约(乳腺RR = 1.26 95% CI:1.02-1.55;宫颈RR = 1.49 95% CI:1.27-1.75;结直肠RR = 1.79 95% CI:1.65-1.93)。邮寄自采宫颈标本的试剂盒增加了无应答者的参与(RR = 2.37 95% CI:1.44-3.90)。虽然一些干预措施确实被证明是有效的,但一些特定的变量可能会影响其有效性和适用性,以有组织的人口为基础的筛查计划。
The European Community recommends the implementation of population-based screening programmes for cervical, breast, and colorectal cancers. This recommendation is supported by many observational studies showing that organised programmes effectively reduce mortality and control the inappropriate use of screening tests. We conducted a systematic review of studies assessing the efficacy of interventions to increase participation in organised population-based screening programs. We included all studies on interventions aimed at increasing screening participation published between 1/1999 and 7/2012. For those published before 1999, we considered the Jepson et al. (2000) review (Health Technol Assess 4:1-133, 2000). Including studies from the Jepson review, we found 69 with quantitative information on interventions in organised screening: 19 for cervical, 26 for breast, 20 colorectal cancers, and 4 for cervical and breast cancer together. Effective interventions were: postal (breast RR = 1,37 95% Confidence Interval (95% CI): 1.25-1.51; cervical RR = 1.71 95% CI: 1.60-1.83; colorectal RR = 1.33 95% CI: 1.17-1.51) and telephone reminders (with heterogeneous methods for implementation); GP’s signature on invitation letter (breast RR = 1.13 95% CI: 1.11-1.16; cervical RR = 1.20 95% CI: 1.10-1.30; colorectal RR = 1.15 95% CI: 1.07-1.24); scheduled appointment instead of open appointment (breast RR = 1.26 95% CI: 1.02-1.55; cervical RR = 1.49 95% CI: 1.27-1.75; colorectal RR = 1.79 95% CI: 1.65-1.93). Mailing a kit for self-sampling cervical specimens increased participation in non-responders (RR = 2.37 95% CI: 1.44-3.90). Although some interventions did prove to be effective, some specific variables may influence their effectiveness in and applicability to organised population-based screening programs.
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