Participation in Competing Strategies for Colorectal Cancer Screening: A Randomized Health Services Study (PICCOLINO Study)
Participation in Competing Strategies for Colorectal Cancer Screening: A Randomized Health Services Study (PICCOLINO Study)
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DOI：
10.1053/j.gastro.2020.11.049
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发表时间：
2021-03-09
期刊：
影响因子：
29.4
通讯作者：
Kaminski, Michal Filip
中科院分区：
文献类型：
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作者：
Pilonis, Nastazja Dagny;Bugajski, Marek;Kaminski, Michal Filip
背景与目的：原发性结肠镜检查和粪便免疫化学检测（FIT）被认为是结直肠癌（CRC）筛查的第一级检测。虽然结肠镜检查被认为是最有效的检查，但FIT可能会获得更高的参与率。目前还不确定提供全人群CRC筛查的最佳策略是什么。方法：这是一项多中心随机卫生服务研究，于2019年1月至2020年3月在波兰结肠镜筛查计划的框架内对筛查初治个体进行。符合条件的候选人以1：1：1的比例随机分配参加3种竞争邀请策略之一：对照（仅邀请筛查结肠镜检查）;顺序（邀请初次结肠镜检查和邀请初始无应答者进行FIT）;或选择（邀请提供结肠镜检查或FIT的选择）。主要结局是在入组研究后18周内参与CRC筛查。次要结局是晚期肿瘤的诊断率。结果：总体而言，12，485人被随机分配到3个研究组。对照组的参与率（17.5%）显著低于序贯策略组（25.8%）和选择策略组（26.5%）（P
BACKGROUND & AIMS: Primary colonoscopy and fecal immunochemical testing (FIT) are considered first-tier tests for colorectal cancer (CRC) screening. Although colonoscopy is considered the most efficacious test, FIT might achieve higher participation rates. It is uncertain what the best strategy is for offering population-wide CRC screening. METHODS: This was a multicenter randomized health services study performed within the framework of the Polish Colonoscopy Screening Program between January 2019 and March 2020 on screening-naive individuals. Eligible candidates were randomly assigned in a 1:1:1 ratio to participate in 1 of 3 competing invitation strategies: control (invitation to screening colonoscopy only); sequential (invitation to primary colonoscopy and invitation for FIT for initial nonresponders); or choice (invitation offering a choice of colonoscopy or FIT). The primary outcome was participation in CRC screening within 18 weeks after enrollment into the study. The secondary outcome was diagnostic yield for advanced neoplasia. RESULTS: Overall, 12,485 individuals were randomized into the 3 study groups. The participation rate in the control group (17.5%) was significantly lower compared with the sequential (25.8%) and choice strategy (26.5%) groups (P