AOU S Giovanni Battista - CPO Piemonte, SCDO Epidemiologia dei Tumori 2, Via S Francesco da Paola 31, 10123 Torino, Italy.
Best Pract Res Clin Gastroenterol. 2010 Aug;24(4):509-20. doi: 10.1016/j.bpg.2010.06.002.
Colorectal Cancer (CRC) screening delivery is a multidisciplinary undertaking, aiming at reducing mortality from and incidence of CRC without adversely affecting the health status of participants. The adoption of a public health perspective involves commitment to ensure equity of access and sustainability of the program over time. We reviewed available evidence concerning predictors of CRC screening uptake and the impact of interventions to improve adoption of screening using conceptual frameworks defining the role of determinants of preventive behaviours and the reach and target of interventions. The results of this review indicate that policy measures aimed at supporting screening delivery, as well as organisational changes, influencing the operational features of preventive services, need to be implemented, in order to allow individual's motivation to be eventually realised. To ensure coverage and equity of access and to maximise the impact of the intervention, policies aimed at implementing organised programs should be adopted, ensuring that participation in screening and any follow-up assessment should not be limited by financial barriers. Participants and providers beliefs may determine the response to different screening modalities. To achieve the desired health impact, an active follow-up of people with screening abnormalities should be implemented, supported by the introduction of infrastructural changes and multidisciplinary team work, which can ensure sustainability over time of effective interventions. Continuous monitoring as well as the adoption of plans to evaluate for program effectiveness represent crucial steps in the implementation of a successful program.
结直肠癌（CRC）筛查的实施是一项多学科的工作，旨在降低 CRC 的死亡率和发病率，同时不影响参与者的健康状况。采取公共卫生的观点意味着需要承诺确保获得 CRC 筛查的公平性和项目的可持续性。我们回顾了有关 CRC 筛查参与率的预测因素以及通过干预措施提高筛查参与率的影响的现有证据，这些干预措施使用定义预防性行为决定因素的概念框架和干预措施的范围和目标来改善筛查的采用。该综述的结果表明，需要实施旨在支持筛查实施的政策措施以及组织变革，以影响预防服务的运作特征，以便最终实现个人的动机。为了确保覆盖率和获得的公平性，并最大限度地提高干预措施的效果，应采用旨在实施有组织计划的政策，以确保筛查和任何后续评估的参与不受财务障碍的限制。参与者和提供者的信念可能决定对不同筛查模式的反应。为了实现预期的健康影响，应实施对有筛查异常的人的积极随访，通过引入基础设施变化和多学科团队合作来支持，以确保有效的干预措施在一段时间内的可持续性。持续监测以及采用评估计划来评估计划的有效性是成功实施计划的关键步骤。
