Tiro Jasmin A, Kamineni Aruna, Levin Theodore R, Zheng Yingye, Schottinger Joanne S, Rutter Carolyn M, Corley Douglas A, Skinner Celette S, Chubak Jessica, Doubeni Chyke A, Halm Ethan A, Gupta Samir, Wernli Karen J, Klabunde Carrie
Authors' Affiliations: Department of Clinical Sciences, University of Texas Southwestern Medical Center and Harold C. Simmons Cancer Center, Dallas, Texas;
Group Health Research Institute;
Cancer Epidemiol Biomarkers Prev. 2014 Jul;23(7):1147-58. doi: 10.1158/1055-9965.EPI-13-1217. Epub 2014 Jun 10.
Reducing colorectal cancer mortality by promoting screening has been a national goal for two decades. The NCI's Population-Based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium is the first federal initiative to foster coordinated, transdisciplinary research evaluating the entire cancer screening process in community settings. PROSPR is creating a central data repository to facilitate research evaluating the breast, cervical, and colorectal cancer screening process across different patient populations, provider types, and delivery systems. Data are being collected and organized at the multiple levels in which individuals are nested (e.g., healthcare systems, facilities, providers, and patients). Here, we describe a conceptual model of the colorectal cancer screening process guiding data collection and highlight critical research questions that will be addressed through pooled data. We also describe the three research centers focused on colorectal cancer screening with respect to study populations, practice settings, and screening policies. PROSPR comprehensively elucidates the complex screening process through observational study, and has potential to improve care delivery beyond the healthcare systems studied. Findings will inform intervention designs and policies to optimize colorectal cancer screening delivery and advance the Institute of Medicine's goals of effective, efficient, coordinated, timely, and safe health care with respect to evidence-based cancer screening.
二十年来，通过促进筛查降低结直肠癌死亡率一直是国家目标。美国国家癌症研究所（NCI）的基于人群的个性化方案优化筛查研究联盟（PROSPR）是首个联邦倡议，旨在推动开展协调一致的跨学科研究，评估社区环境中的整个癌症筛查过程。PROSPR正在创建一个中央数据存储库，以促进对不同患者群体、医疗服务提供者类型和服务提供系统的乳腺癌、宫颈癌和结直肠癌筛查过程进行研究评估。数据正在个体所处的多个层次（如医疗系统、机构、医疗服务提供者和患者）进行收集和整理。在此，我们描述一个指导数据收集的结直肠癌筛查过程概念模型，并强调将通过汇总数据解决的关键研究问题。我们还介绍了专注于结直肠癌筛查的三个研究中心在研究人群、实践环境和筛查政策方面的情况。PROSPR通过观察性研究全面阐明了复杂的筛查过程，并且有可能改善所研究医疗系统之外的医疗服务提供。研究结果将为干预设计和政策提供信息，以优化结直肠癌筛查服务，并推进医学研究所关于基于循证的癌症筛查实现有效、高效、协调、及时和安全医疗保健的目标。
