Williams E M, Vessey M P
Department of Community Medicine and General Practice, Radcliffe Infirmary, Oxford.
J Public Health Med. 1990 Feb;12(1):51-5. doi: 10.1093/oxfordjournals.pubmed.a042506.
The uptake of breast cancer screening in women aged 45-64 years, living in Aylesbury Vale district, was determined between 1984 and 1988. During this period, self-referral gave way to invitation as the method of gaining access to the service. In the initial period of open access the estimated uptake was 27.9 per cent. A pilot study of response to invitation (and reminder) in two general practices resulted in a compliance of 80.6 per cent. Extended to 20 general practices in Aylesbury Vale, overall compliance with invitation was 73.7 per cent. The response amongst previously screened volunteers was higher (91.5 per cent) than amongst unscreened women (67.6 per cent). There was no significant trend in compliance with age although the oldest women had the lowest uptake. Second round compliance in the two pilot practices reduced to 77 per cent, with 86.1 per cent of a cohort of screened women responding to a second offer of screening. The implications of these results for the national breast cancer screening programme are discussed together with the difficulties associated with the routine derivation of uptake. It is concluded that not only must the accuracy of population registers be improved, but also standard definitions of uptake measurements should be agreed and adopted.
对居住在艾尔斯伯里谷区年龄在45至64岁的女性进行乳腺癌筛查的情况,在1984年至1988年期间进行了测定。在此期间,自我转诊被邀请就诊所取代,成为获得该服务的方式。在开放就诊的初期,估计接受率为27.9%。在两个全科诊所进行的关于对邀请(及提醒)的反应的试点研究,得到的依从率为80.6%。推广至艾尔斯伯里谷区的20个全科诊所后,对邀请的总体依从率为73.7%。之前接受过筛查的志愿者的反应率(91.5%)高于未接受筛查的女性(67.6%)。尽管年龄最大的女性接受率最低,但依从率并没有随年龄呈现显著趋势。两个试点诊所第二轮的依从率降至了77%,一组接受过筛查的女性中有86.1%对第二轮筛查邀请做出了回应。讨论了这些结果对全国乳腺癌筛查计划的影响以及与常规计算接受率相关的困难。得出的结论是,不仅必须提高人口登记册的准确性,而且还应商定并采用接受率测量的标准定义。