EARLY DETECTION OF COLON/RECTAL CANCER

这项研究的主要目的是评估 在一大批固定人群中开展的结直肠癌筛查计划 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。这个 1985年开始实施的筛查计划包括 标准化实验室隐血检测--一种诊断算法 对血隐匿性阳性的随访，医生教育，以及 通过肿瘤登记信息进行计算机化监测 系统。 筛查计划的有效性在提高 无症状诊断和早期疾病的比例将 通过计划前/计划后时间序列进行评估 病例/对照分析。研究数据来源于医学 1980~1988年及2003年1,100例确诊病例记录 住院病人和门诊病人的计算机肿瘤登记 信息系统。人口和亚组分析将是 用于估计与筛选相关的平均交货期 并对长度偏差抽样的效果进行评估。直接和 将估计筛查计划的间接成本，并 方案在产生各种成果方面的成本效益 将会被评估。

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.