Program to Improve Colorectal Cancer Screening in a Low-Income, Racially Diverse Population: A Randomized Controlled Trial
Program to Improve Colorectal Cancer Screening in a Low-Income, Racially Diverse Population: A Randomized Controlled Trial
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DOI：
10.1370/afm.1381
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发表时间：
2012-09-01
影响因子：
4.4
通讯作者：
Choucair, Bechara N.
中科院分区：
文献类型：
--
作者：
Jean-Jacques, Muriel;Kaleba, Erin O.;Choucair, Bechara N.
需要更有效的策略来提高结直肠癌筛查率，特别是在穷人、少数民族和英语水平有限的人中。我们研究了是否粪便潜血试验（FOBT）试剂盒直接邮寄给逾期的患者，这样的筛选是一种有效的方法，以提高筛选在这population.METHODS所有的成年人年龄在50至80岁谁没有文件被最新的结直肠癌筛查截至2009年12月31日，在过去的18个月内至少有2次到社区卫生中心就诊的患者被随机分配到外展干预或常规护理。外展组的患者邮寄了结肠直肠癌情况说明书和FOBT试剂盒。常规护理组的患者可在常规临床医生访视期间转诊进行筛查。主要结局是在开始外展方案后4个月完成结直肠癌筛查（通过FOBT、乙状结肠镜检查或结肠镜检查）。结果的措施进行了比较，使用Fisher精确test.Results分析的基础上分配到外展干预和98例患者分配到常规护理的104例。总体而言，外展组中30%的患者在研究期间完成了结直肠癌筛查，而常规护理组中只有5%的患者完成了筛查（P
PURPOSE More effective strategies are needed to improve rates of colorectal cancer screening, particularly among the poor, racial and ethnic minorities, and individuals with limited English proficiency. We examined whether the direct mailing of fecal occult blood testing (FOBT) kits to patients overdue for such screening is an effective way to improve screening in this population.METHODS All adults aged 50 to 80 years who did not have documentation of being up to date with colorectal cancer screening as of December 31, 2009, and who had had at least 2 visits to the community health center in the prior 18 months were randomized to the outreach intervention or usual care. Patients in the outreach group were mailed a colorectal cancer fact sheet and FOBT kit. Patients in the usual care group could be referred for screening during usual clinician visits. The primary outcome was completion of colorectal cancer screening (by FOBT, sigmoidoscopy, or colonoscopy) 4 months after initiation of the outreach protocol. Outcome measures were compared using the Fisher exact test.RESULTS Analyses were based on 104 patients assigned to the outreach intervention and 98 patients assigned to usual care. In all, 30% of patients in the outreach group completed colorectal cancer screening during the study period, compared with 5% of patients in the usual care group (P