Timely follow-up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium.
Timely follow-up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium.
复制标题
DOI：
10.3322/caac.21452
复制
发表时间：
2018-05
期刊：
影响因子：
--
通讯作者：
Armstrong K
中科院分区：
文献类型：
--
作者：
Doubeni CA;Gabler NB;Wheeler CM;McCarthy AM;Castle PE;Halm EA;Schnall MD;Skinner CS;Tosteson ANA;Weaver DL;Vachani A;Mehta SJ;Rendle KA;Fedewa SA;Corley DA;Armstrong K
对阳性癌症筛查结果的及时随访仍不理想，为优化诊断检测及时性的决策提供信息的证据基础尚不清楚。本系统综述评价了已发表的关于乳腺癌、宫颈癌、结直肠癌和肺癌筛查阳性后随访时间的研究。在大多数研究中，癌症之间可用证据的质量非常低或较低，与适应症混淆的相关性可能减弱或逆转。总体而言，有证据表明，随着癌症类型内部和之间变化的等待时间的延长，癌症结果较差的风险增加，这支持在阳性结果后尽快进行诊断测试，但具体时间目标的证据有限。在这些限制范围内，我们提供了我们对癌症具体建议的意见，以跟踪时间以及现有指南与当前证据的关系。等待时间设置应考虑患者担忧、因等待时间延长而失访的可能性以及可用资源。需要进行研究，以更好地指导诊断后续行动的及时性，包括考虑患者的偏好和现有障碍，同时解决方法上的弱点。还需要进行研究，以确定有效的干预措施，减少诊断检测的等待时间，特别是在服务不足或资源匮乏的环境中。
Timely follow-up for positive cancer screening results remains suboptimal and the evidence base to inform decisions on optimizing the timeliness of diagnostic testing is unclear. This systematic review evaluated published studies regarding time to follow-up after a positive screening for breast, cervical, colorectal, and lung cancers. The quality of available evidence was very-low or low across cancers with potential attenuated or reversed associations from confounding by indication in most studies. Overall, evidence suggested that the risk for poorer cancer outcomes rises with longer wait times that varies within and across cancer types, which supports performing diagnostic testing as soon as feasible after the positive result, but evidence for specific time targets is limited. Within these limitations, we provide our opinion on cancer-specific recommendations for times to follow-up and how existing guidelines relate to the current evidence. Thresholds set should consider patient worry, potential for loss to follow-up with prolonged wait times, and available resources. Research is needed to better guide the timeliness of diagnostic follow-up, including considerations for patient preferences and existing barriers, while addressing methodological weaknesses. Research is also needed to identify effective interventions for reducing wait times for diagnostic testing, particularly in underserved or low-resource settings.
登录
查看更多内容
影响因子：
3.7
作者：
Castle, Philip E.;Sideri, Mario;Schiffman, Mark
通讯作者：
Schiffman, Mark
DOI：
10.1158/1055-9965.epi-12-0532
发表时间：
2012-10
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Battaglia TA;Bak SM;Heeren T;Chen CA;Kalish R;Tringale S;Taylor JO;Lottero B;Egan AP;Thakrar N;Freund KM
通讯作者：
Freund KM
DOI：
10.1002/2327-6924.12227
发表时间：
2015-05-01
影响因子：
1.2
作者：
Carter-Harris, Lisa
通讯作者：
Carter-Harris, Lisa
影响因子：
3
作者：
Brookhart MA;Stürmer T;Glynn RJ;Rassen J;Schneeweiss S
通讯作者：
Schneeweiss S
影响因子：
5.2
作者：
Caplan L
通讯作者：
Caplan L