EARLY DETECTION OF COLON/RECTAL CANCER

本研究的主要目的是评估 在一个大的确定的人群中进行结肠直肠筛查计划， HMO成员使用具有已知链接的中间端点， 癌症的后续发展和进展。 的 1985年实施的筛查计划包括： 标准化实验室潜血试验，诊断算法 用于随访阳性血吸虫病、医生教育，以及 通过肿瘤登记信息进行计算机化监测 系统 筛查计划的有效性 无症状诊断和早期疾病的比例将 通过程序前/程序后时间序列进行评估， 病例/对照分析。 研究数据来源于医学 1980年至1988年期间诊断的1，100例病例记录， 计算机肿瘤登记，住院和门诊 信息系统。 将进行人群和亚组分析 用于估计与筛选相关的平均前置时间 并评估长度偏差抽样的影响。 直接和 将估计筛查计划的间接费用， 方案在产生各种成果方面的成本效益 将被评估。

The primary purpose of this study is to assess the effectiveness of a colorectal screening program in a large defined population of HMO members using intermediate endpoints with known links to the subsequent development and progression of cancer. The screening program, which was implemented in 1985, consists of standardized laboratory hemoccult testing, a diagnostic algorithm for follow-up of positive hemoccults, physician education, and computerized monitoring through a Tumor Registry Information System. The effectiveness of the screening program in increasing proportion of asymptomatic diagnoses and early stage disease will be assessed through pre-program/post-program time series and case/control analyses. The study data is derived from the medical records of 1,100 cases diagnosed during 1980-1988 and from computerized Tumor Registry, inpatient and outpatient information systems. Population and subgroup analyses will be used to estimate average lead time associated with the screening and to assess the effects of length bias sampling. Direct and indirect costs of the screening program will be estimated and the cost-effectiveness of the program in producing various outcomes will be assessed.