Is the type of test used for mass colorectal cancer screening a determinant of compliance? A cluster-randomized controlled trial comparing fecal occult blood testing with flexible sigmoidoscopy
Is the type of test used for mass colorectal cancer screening a determinant of compliance? A cluster-randomized controlled trial comparing fecal occult blood testing with flexible sigmoidoscopy
复制标题
DOI：
10.1016/j.cdp.2006.03.009
复制
发表时间：
2006-01-01
影响因子：
--
通讯作者：
Guasticchi, Gabriella
中科院分区：
文献类型：
--
作者：
Federici, Antonio;Marinacci, Chiara;Guasticchi, Gabriella
背景：结直肠癌筛查的有效性已得到证实，国际指南推荐三种不同的筛查方法：粪便隐血检查、乙状结肠镜检查和结肠镜检查。虽然筛查程序的有效性取决于所获得的依从性，但测试类型对依从性的作用尚未得到充分研究。目的：探讨筛查试验类型（即粪便潜血试验或乙状结肠镜检查）对结直肠癌筛查方案依从性的影响。研究对象和方法：采用双组随机试验。我们随机分配了20家全科医生诊所，平均有150名年龄在50到74岁之间的患者。结果：1449例患者行粪便隐血检查，1538例行乙状结肠镜检查。粪便隐血检查获得更高的依从性：17.2% （95%CI 12.5-25.7）对7.0% （95%CI 5.7-9.0）。社会经济地位是测试类型的影响调节因子：低社会经济阶层的测试类型的影响较小。结论：用于结直肠癌筛查试验的类型是参与的决定因素。在低依从性地区，提供粪便隐血检查比灵活乙状结肠镜检查的依从性更好。(c) 2006年国际预防肿瘤学会。Elsevier Ltd.出版。版权所有。
Background: The efficacy of colorectal cancer screening has been proved, and three different screening tests are recommended by international guidelines: the faecal occult blood test, flexible sigmoidoscopy and colonoscopy. While the effectiveness of a screening program depends on the compliance obtained, the role of the type of test on compliance has not yet been sufficiently studied. Aims: To measure the effect of the type of screening test used, i.e. faecal occult blood test or flexible sigmoidoscopy, on the compliance to colorectal cancer screening programs. Subjects and methods: A cluster-randomized two-arm trial was conducted. We randomly assigned 20 GP's practices that had an average of 150 patients between 50 and 74 years old. Results: 1449 individuals were referred to faecal occult blood test and 1538 to flexible sigmoidoscopy. The faecal occult blood test obtained higher compliance: 17.2% (95%CI 12.5-25.7) versus 7.0% (95%CI 5.7-9.0). The socio-economic status was an effect modifier of the test type: the effect of the type of test was smaller in low socioeconomic classes. Conclusions: The type of screening test used for colorectal cancer is a determinant of participation. In a low compliance area, better compliance will result from offering the faecal occult blood test than from the flexible sigmoidoscopy. (c) 2006 International Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved.