Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 30310, USA.
Cancer. 2010 Feb 15;116(4):922-9. doi: 10.1002/cncr.24842.
Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. CRC incidence and mortality rates are higher among blacks than among whites, and screening rates are lower in blacks than in whites. For the current study, the authors tested 3 interventions that were intended to increase the rate of CRC screening among African Americans.
The following interventions were chosen to address evidence gaps in the Centers for Disease Control and Prevention's Guide to Community Preventive Services: one-on-one education, group education, and reducing out-of-pocket costs. Three hundred sixty-nine African-American men and women aged > or =50 years were enrolled in this randomized, controlled community intervention trial. The main outcome measures were postintervention increase in CRC knowledge and obtaining a screening test within 6 months.
There was substantial attrition: Two hundred fifty-seven participants completed the intervention and were available for follow-up 3 months to 6 months later. Among completers, there were significant increases in knowledge in both educational cohorts but in neither of the other 2 cohorts. By the 6-month follow-up, 17.7% (11 of 62 participants) of the Control cohort reported having undergone screening compared with 33.9% (22 of 65 participants) of the Group Education cohort (P = .039). Screening rate increases in the other 2 cohorts were not statistically significant.
The current results indicated that group education could increase CRC cancer screening rates among African Americans. The screening rate of <35% in a group of individuals who participated in an educational program through multiple sessions over a period of several weeks indicated that there still are barriers to overcome.
在美国，结直肠癌（CRC）是癌症死亡的第二大主要原因。黑人群体 CRC 的发病率和死亡率高于白人群体，且筛查率也低于白人群体。在当前的研究中，作者测试了 3 种干预措施，旨在提高非裔美国人 CRC 筛查率。
选择以下干预措施来解决疾病控制与预防中心（CDC）社区预防服务指南中的证据空白：一对一教育、群体教育和降低自付费用。这项随机对照社区干预试验纳入了 369 名年龄≥50 岁的非裔美国男性和女性。主要结局指标是干预后的 CRC 知识增加和在 6 个月内进行筛查测试。
有大量的参与者流失：257 名参与者完成了干预，并在 3 到 6 个月后进行了随访。在完成干预的参与者中，两个教育组的知识都有显著增加，但另外两组则没有。在 6 个月的随访中，对照组中有 17.7%（62 名参与者中的 11 名）报告进行了筛查，而群体教育组中有 33.9%（65 名参与者中的 22 名）（P =.039）。其他两组的筛查率增加则不具有统计学意义。
目前的结果表明，群体教育可以提高非裔美国人 CRC 筛查率。在一个参加了多个课程、持续数周的教育项目的个体组中，筛查率<35%表明仍然存在需要克服的障碍。
