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向前推进:利用疾病预防控制中心结直肠癌筛查示范项目的经验指导未来结直肠癌规划工作。

Moving forward: using the experience of the CDCs' Colorectal Cancer Screening Demonstration Program to guide future colorectal cancer programming efforts.

机构信息

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA.

出版信息

Cancer. 2013 Aug 1;119 Suppl 15:2940-6. doi: 10.1002/cncr.28155.

Abstract

BACKGROUND

The Centers for Disease Control and Prevention (CDC) established and supported a 4-year Colorectal Cancer Screening Demonstration Program (CRCSDP) from 2005 to 2009 for low-income, under- or uninsured men and women aged 50-64 at 5 sites in the United States.

METHODS

A multiple methods evaluation was conducted including 1) a longitudinal, comparative case study of program implementation, 2) the collection and analysis of client-level screening and diagnostic services outcome data, and 3) the collection and analysis of program- and patient-level cost data.

RESULTS

Several themes emerged from the results reported in the series of articles in this Supplement. These included the benefit of building on an existing infrastructure, strengths and weakness of both the 2 most frequently used screening tests (colonoscopy and fecal occult blood tests), variability in costs of maintaining this screening program, and the importance of measuring the quality of screening tests. Population-level evaluation questions could not be answered because of the small size of the participating population and the limited time frame of the evaluation. The comprehensive evaluation of the program determined overall feasibility of this effort.

CONCLUSIONS

Critical lessons learned through the implementation and evaluation of the CDC's CRCSDP led to the development of a larger population-based program, the CDC's Colorectal Cancer Control Program (CRCCP).

摘要

背景

美国疾病控制与预防中心(CDC)于 2005 年至 2009 年在五个地点为 50-64 岁的低收入、未投保或未投保的男性和女性设立并支持了为期四年的大肠癌筛查示范计划(CRCSDP)。

方法

采用多种方法进行评估,包括 1)对计划实施情况进行纵向、比较性案例研究,2)收集和分析客户层面的筛查和诊断服务结果数据,以及 3)收集和分析计划和患者层面的成本数据。

结果

从本增刊中一系列文章报告的结果中出现了几个主题。其中包括利用现有基础设施的好处、两种最常用的筛查测试(结肠镜检查和粪便潜血测试)的优缺点、维持这种筛查计划的成本的可变性,以及筛查测试质量的重要性。由于参与人口规模较小和评估时间有限,无法回答人群水平的评估问题。对该计划的综合评估确定了这一努力的总体可行性。

结论

通过实施和评估 CDC 的大肠癌筛查示范计划,我们汲取了重要的经验教训,这促成了一个更大的基于人群的计划——CDC 的大肠癌控制计划(CRCCP)的发展。

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