Effectiveness and Cost of Organized Outreach for Colorectal Cancer Screening: A Randomized, Controlled Trial
Effectiveness and Cost of Organized Outreach for Colorectal Cancer Screening: A Randomized, Controlled Trial
复制标题
DOI：
10.1093/jnci/djz110
复制
发表时间：
2020-03-01
影响因子：
10.3
通讯作者：
Ladabaum, Uri
中科院分区：
文献类型：
--
作者：
Somsouk, Ma;Rachocki, Carly;Ladabaum, Uri
背景：结直肠癌(CRC)筛查仍未得到充分利用，尤其是在安全网系统中。本研究的目的是确定使用粪便免疫化学检测(FITS)进行有组织的外展的效果、成本和成本-效果与常规护理的比较。方法：从8个参与初级保健安全网诊所的50-75岁符合结直肠癌筛查条件的患者随机分配到常规护理和单独常规护理的外展干预。干预包括邮寄明信片和电话，然后是邮寄的Fit试剂盒，如果Fit试剂盒没有退还，还会打电话提醒。主要成果是在1年内参加筛查，并对外联活动进行微观成本分析，并嵌入外联的长期成本效益。结果：将5386例患者随机分为干预组和常规护理组各5434例。干预组Fit筛查高于对照组(57.9%vs37.4%，P
Background: Colorectal cancer (CRC) screening remains underused, especially in safety-net systems. The objective of this study was to determine the effectiveness, costs, and cost-effectiveness of organized outreach using fecal immunochemical tests (FITs) compared with usual care.Methods: Patients age 50-75 years eligible for CRC screening from eight participating primary care safety-net clinics were randomly assigned to outreach intervention with usual care vs usual care alone. The intervention included a mailed postcard and call, followed by a mailed FIT kit, and a reminder phone call if the FIT kit was not returned. The primary outcome was screening participation at 1 year and a microcosting analysis of the outreach activities with embedded long-term cost-effectiveness of outreach. All statistical tests were two-sided.Results: A total of 5386 patients were randomly assigned to the intervention group and 5434 to usual care. FIT screening was statistically significantly higher in the intervention group than in the control group (57.9% vs 37.4%, P