Public Health England West Midlands, Birmingham, UK.
J Public Health (Oxf). 2018 Mar 1;40(1):e46-e58. doi: 10.1093/pubmed/fdw147.
Colorectal cancer (CRC) screening using faecal occult blood or faecal immunological testing (FOBT/FIT) involves completion of a screening test-then if required a follow-up diagnostic test.
A systematic review, of EMBASE, MEDLINE, the Cochrane Library and Google Scholar, of studies up to 2016. Studies explored characteristics behind, reasons for and interventions to reduce incomplete diagnostic testing after a positive FOBT/FIT in CRC screening.
A total of 68 articles were included (63 studies). There is evidence of disparities in uptake by socioeconomic position and ethnicity, as well as geographic remoteness. Positive health beliefs, health knowledge and CRC screening attendance history are associated with increased diagnostic testing. Facets of organised screening, including performance feedback and funding improve follow-up-whilst guidelines increase diagnostic testing and reduce inappropriate exclusions. Between 2 and 11% of participants refuse follow-up, with perception of pain critical. Interventions, notably a screening specialist to aid the patient journey, as well as tracking and reminder systems, can increase diagnostic testing.
Although rates of non-attendance in those eligible are low, this represents a group with health care need. Disparities must be eliminated to alleviate wider health inequity. Organised, screening can reduce incomplete diagnostic testing, as can accessible health information.
结直肠癌（CRC）筛查采用粪便潜血或粪便免疫检测（FOBT/FIT），包括完成筛查测试-然后如果需要，进行后续诊断测试。
对 EMBASE、MEDLINE、Cochrane 图书馆和 Google Scholar 进行系统回顾，检索截至 2016 年的研究。这些研究探讨了在 CRC 筛查中，FOBT/FIT 阳性后，未完成诊断检测的原因、背后的特征以及干预措施。
共纳入 68 篇文章（63 项研究）。在社会经济地位和种族以及地理偏远程度方面，存在检测率差异的证据。积极的健康信念、健康知识和 CRC 筛查参与史与增加诊断检测有关。有组织的筛查方面，包括绩效反馈和资金投入可改善随访情况-而指南则可增加诊断检测并减少不适当的排除。有 2%至 11%的参与者拒绝随访，对疼痛的感知至关重要。干预措施，特别是帮助患者完成检测过程的筛查专家，以及跟踪和提醒系统，可以增加诊断检测。
尽管符合条件的人群中未参与筛查的比例较低，但这代表了有医疗需求的人群。必须消除差异，以减轻更广泛的健康不平等。有组织的筛查，以及可获得的健康信息，可以减少未完成的诊断检测。
