Effect of gender, age and deprivation on key performance indicators in a FOBT-based colorectal screening programme
Effect of gender, age and deprivation on key performance indicators in a FOBT-based colorectal screening programme
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DOI：
10.1258/jms.2010.009120
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发表时间：
2010-01-01
影响因子：
2.9
通讯作者：
Fraser, C.
中科院分区：
文献类型：
--
作者：
Steele, R. J. C.;Kostourou, I.;Fraser, C.
2000年3月至2006年5月期间，在苏格兰东北部对所有年龄在50-69岁的个体进行了两年一次的愈创木粪隐血试验（gFOBT）结直肠筛查的示范试点。根据苏格兰多重障碍指数（SIMD）分为四个年龄组和五个剥夺类别，并在这些组内分析关键绩效指标。结果在所有轮次中，gFOBT的摄取随年龄增加而增加（P < 0.001），随着剥夺程度的增加而降低（P < 0.001），并且在所有年龄和所有SIMD组中女性始终高于男性。此外，在gFOBT阳性的男性中，剥夺的增加与结肠镜检查的摄取呈负相关（P < 0.001），尽管在女性中未观察到这种影响。在所有轮次中，男性和女性的阳性率均随着年龄的增长（P < 0.001）和剥夺程度的增加（P < 0.001）而增加，尽管在所有年龄和SIMD类别中，男性的阳性率均高于女性。癌症检出率随年龄增长而增加（P < 0.001），在所有年龄和SIMD类别中，男性高于女性，但与剥夺无关。在两种性别中，癌症的阳性预测值（PPV）随着年龄的增长而增加（P < 0.001），并随剥夺程度的增加而降低（P < 0.001），在所有轮次中，男性在所有年龄和SIMD类别中始终高于女性。结论在这个以人群为基础的结直肠筛查项目中，性别、年龄和剥夺对关键性能指标有显著影响，这对筛查方案的评估和旨在减少不平等的战略都有影响。
Objectives To assess the effect of gender, age and deprivation on key performance indicators in a colorectal cancer screening programme.Setting Between March 2000 and May 2006 a demonstration pilot of biennial guaiac faecal occult blood test (gFOBT) colorectal screening was carried out in North-East Scotland for all individuals aged 50-69 years.Methods The relevant populations were subdivided, by gender, into four age groups and into five deprivation categories according to the Scottish Index of Multiple Deprivation (SIMD), and key performance indicators analysed within these groups.Results In all rounds, uptake of the gFOBT increased with age (P < 0.001), decreased with increasing deprivation in both genders (P < 0.001), and was consistently higher in women than in men in all age and all SIMD groups. In addition, increasing deprivation was negatively associated with uptake of colonoscopy in men with a positive gFOBT (P < 0.001) although this effect was not observed in women. Positivity rates increased with age (P < 0.001) and increasing deprivation (P < 0.001) in both genders in all rounds, although they were higher in men than in women for all age and SIMD categories. Cancer detection rates increased with age (P < 0.001), were higher in men than in women in all age and SIMD categories, but were not consistently related to deprivation. In both genders, the positive predictive value (PPV) for cancer increased with age (P < 0.001) and decreased with increasing deprivation (P < 0.001) in all rounds and was consistently higher in men than in women in all age and SIMD categories.Conclusions In this population-based colorectal screening programme gender, age, and deprivation had marked effects on key performance indicators, and this has implications both for the evaluation of screening programmes and for strategies designed to reduce inequalities.