Dietrich Allen J, Tobin Jonathan N, Cassells Andrea, Robinson Christina M, Greene Mary Ann, Sox Carol Hill, Beach Michael L, DuHamel Katherine N, Younge Richard G
Norris Cotton Cancer Center and Dartmouth Medical School, Hanover, New Hampshire 03755, USA.
Ann Intern Med. 2006 Apr 18;144(8):563-71. doi: 10.7326/0003-4819-144-8-200604180-00006.
Minority and low-income women receive fewer cancer screenings than other women.
To evaluate the effect of a telephone support intervention to increase rates of breast, cervical, and colorectal cancer screening among minority and low-income women.
Randomized, controlled trial conducted between November 2001 and April 2004.
11 community and migrant health centers in New York City.
1413 women who were overdue for cancer screening.
Over 18 months, women assigned to the intervention group received an average of 4 calls from prevention care managers and women assigned to the control group received usual care. Follow-up data were available for 99% of women, and 91% of the intervention group received at least 1 call.
Medical record documentation of mammography, Papanicolaou testing, and colorectal cancer screening according to U.S. Preventive Services Task Force recommendations.
The proportion of women who had mammography increased from 0.58 to 0.68 with the intervention and decreased from 0.60 to 0.58 with usual care; the proportion who had Papanicolaou testing increased from 0.71 to 0.78 with the intervention and was unchanged with usual care; and the proportion who had colorectal screening increased from 0.39 to 0.63 with the intervention and from 0.39 to 0.50 with usual care. The difference in the change in screening rates between groups was 0.12 for mammography (95% CI, 0.06 to 0.19), 0.07 for Papanicolaou testing (CI, 0.01 to 0.12), and 0.13 for colorectal screening (CI, 0.07 to 0.19). The proportion of women who were up to date for 3 tests increased from 0.21 to 0.43 with the intervention.
Participants were from 1 city and had access to a regular source of care. Medical records may not have captured all cancer screenings.
Telephone support can improve cancer screening rates among women who visit community and migrant health centers. The intervention seems to be well suited to health plans, large medical groups, and other organizations that seek to increase cancer screening rates and to address disparities in care.
少数族裔和低收入女性接受癌症筛查的次数少于其他女性。
评估电话支持干预措施对提高少数族裔和低收入女性乳腺癌、宫颈癌和结直肠癌筛查率的效果。
2001年11月至2004年4月进行的随机对照试验。
纽约市的11个社区和移民健康中心。
1413名逾期未进行癌症筛查的女性。
在18个月的时间里，被分配到干预组的女性平均接到预防护理经理打来的4次电话，被分配到对照组的女性接受常规护理。99%的女性有随访数据，干预组中91%的女性至少接到过1次电话。
根据美国预防服务工作组的建议，通过病历记录来评估乳房X光检查、巴氏试验和结直肠癌筛查情况。
接受干预后，进行乳房X光检查的女性比例从0.58增至0.68，接受常规护理的女性这一比例从0.60降至0.58；接受干预后，进行巴氏试验的女性比例从0.71增至0.78，接受常规护理的女性这一比例未变；接受干预后，进行结直肠癌筛查的女性比例从0.39增至0.63，接受常规护理的女性这一比例从0.39增至0.50。两组筛查率变化的差异在乳房X光检查方面为0.12（95%CI，0.06至0.19），在巴氏试验方面为0.07（CI，0.01至0.12），在结直肠癌筛查方面为0.13（CI，0.07至0.19）。接受干预后，三项检查均达最新标准的女性比例从0.21增至0.43。
参与者来自同一个城市，且能获得常规医疗服务。病历可能未涵盖所有癌症筛查情况。
电话支持可提高到社区和移民健康中心就诊的女性的癌症筛查率。该干预措施似乎非常适合那些旨在提高癌症筛查率并解决医疗服务差异问题的健康计划、大型医疗集团及其他组织。
