Wang Ching-Yun, de Dieu Tapsoba Jean, Anderson Melissa L, Vernon Sally W, Chubak Jessica, Fuller Sharon, Green Beverly B
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center;
Group Health Research Institute;
Cancer Epidemiol Biomarkers Prev. 2014 Aug;23(8):1683-8. doi: 10.1158/1055-9965.EPI-14-0270. Epub 2014 Jun 2.
Understanding how interventions affect time to completion of colorectal cancer screening might assist in planning and delivering population-based screening interventions. The Systems of Support to Increase Colorectal Cancer Screening (SOS) study was conducted between 2008 and 2011 at 21 primary care medical centers in Western Washington. Participants in the study, ages 50 to 73 years, were eligible if they were enrolled in Group Health (Seattle, WA) and were due for colorectal cancer screening. Of note, 4,675 recruited participants were randomized to usual care or one of three interventions with incremental levels of systems of support for completion of colorectal cancer screening. We conducted time to screening analyses of the SOS data in years 1 and 2. We investigated whether these effects were time-varying. For year 1, the intervention effects on the time to completion of colorectal cancer screening were the strongest during the first two post-randomization months and then decreased, with no significant effect after the fifth month. For year 2, the intervention effects on the time to colorectal cancer screening increased from the first to the third month and then decreased, with no significant effect after the fifth month. Hence, each of the interventions to increase colorectal cancer screening had its greatest effect within the first 3 months after being offered to participants. Future studies should test whether booster interventions offered later could increase screening rate among those who remain unscreened. Additional research is needed to develop intervention strategies for colorectal cancer screening that focus on sustained behavior over time.
了解干预措施如何影响结直肠癌筛查完成时间，可能有助于规划和实施基于人群的筛查干预措施。提高结直肠癌筛查支持系统（SOS）研究于2008年至2011年在华盛顿州西部的21个初级保健医疗中心进行。该研究的参与者年龄在50至73岁之间，若他们参加了Group Health（华盛顿州西雅图）且应进行结直肠癌筛查，则符合条件。值得注意的是，4675名招募的参与者被随机分配到常规护理组或三种干预措施之一，这三种干预措施对完成结直肠癌筛查的支持系统水平逐步提高。我们对SOS数据的第1年和第2年进行了筛查时间分析。我们调查了这些影响是否随时间变化。在第1年，干预措施对结直肠癌筛查完成时间的影响在随机分组后的前两个月最强，然后下降，在第5个月后无显著影响。在第2年，干预措施对结直肠癌筛查时间的影响从第1个月到第3个月增加，然后下降，在第5个月后无显著影响。因此，每项增加结直肠癌筛查的干预措施在向参与者提供后的前3个月内效果最大。未来的研究应测试后期提供的强化干预措施是否能提高未筛查者的筛查率。还需要进行更多研究，以制定侧重于长期持续行为的结直肠癌筛查干预策略。
