Comité Départemental Des Cancers (CDC-93), 41 avenue de Verdun, 93146, Bondy, France.
CHU de Lyon, Service de Biostatistique162 Avenue Lacassagne, 69424, Lyon, Cedex 03, France; Laboratoire Biostatistique Santé Université Claude Bernard Lyon I UMR CNRS 5558, France.
Public Health. 2019 Aug;173:33-41. doi: 10.1016/j.puhe.2019.05.020. Epub 2019 Jun 25.
From 2009 to 2013, the French colorectal cancer screening program (CRCSP) provided for a medical phase and a phase of systematic mailing of the test kit (SMTK) to people who could not participate in the medical phase. After 2013, the SMTK was abandoned in most districts. This study aims to analyze the impact of this termination.
This was a descriptive and cohort study.
The study concerned a cohort of 143,989 people (aged 50-74 years) living in Seine-Saint-Denis (France), invited to participate in the 2013 campaign (with SMTK) and in the 2015 campaign (without SMTK). The impact of SMTK termination was analyzed in terms of the difference between the participation rates and between the delay (expected vs observed) in performing the screening test in 2015. These differences were described based on previous solicitation in the CRCSP. Expected rates and expected delay were estimated in a Monte Carlo simulation.
The participation rate observed (20.0%) was higher than expected (16.1% [15.9-16.3]). People who have never had a SMTK between 2007 and 2013 (80.0% [79.3-80.7] vs 69.6%) and those who participated in all campaigns before 2015 (97.0% [96.7-97.3] vs 82.6%) had an observed rate lower than expected. The delay observed (4.2 months) was longer than expected (2.5 months).
The sudden termination certainly contributed to the extension of the delay. However, it did not have a major impact on the participation rate, partly due to information campaigns on the new screening test. In this cohort, the low participation would be explained better by the behavior in the previous campaigns than by the lack of SMTK.
从 2009 年到 2013 年，法国结直肠癌筛查计划（CRCSP）提供了医疗阶段和系统邮寄检测试剂盒（SMTK）阶段，供无法参加医疗阶段的人使用。2013 年后，SMTK 在大多数地区被放弃。本研究旨在分析这一终止的影响。
这是一项描述性和队列研究。
该研究涉及居住在塞纳-圣但尼（法国）的 143989 人（年龄在 50-74 岁之间）队列，邀请他们参加 2013 年（有 SMTK）和 2015 年（无 SMTK）的活动。根据 CRCSP 之前的邀请，分析 SMTK 终止对 2015 年参与率和筛查试验预期延迟（观察与预期）的影响。这些差异基于蒙特卡罗模拟进行了描述。
观察到的参与率（20.0%）高于预期（16.1%[15.9-16.3]）。从未在 2007 年至 2013 年之间接受过 SMTK 的人（80.0%[79.3-80.7] 与 69.6%）和参加过 2015 年之前所有活动的人（97.0%[96.7-97.3]与 82.6%）的观察到的参与率低于预期。观察到的延迟（4.2 个月）长于预期（2.5 个月）。
突然终止肯定导致了延迟的延长。然而，它对参与率的影响不大，部分原因是新筛查试验的宣传。在这个队列中，低参与率更多地是由前几轮活动中的行为解释的，而不是由于缺乏 SMTK。
