Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2021 Sep;61(3):402-409. doi: 10.1016/j.amepre.2021.03.002. Epub 2021 May 14.
The Centers for Disease Control and Prevention administers the Colorectal Cancer Control Program to increase colorectal cancer screening rates among people aged 50-75 years in areas where rates are lower than state or national levels. The aim of this study is to better understand the effectiveness of specific Colorectal Cancer Control Program components.
The study population included clinics enrolled in the Colorectal Cancer Control Program during Years 1 and 2. Clinic data collected by the Centers for Disease Control and Prevention annually from 2015 to 2017 for program evaluation were used. The outcome variable was screening rate change through Program Year 2, and predictor variables were a new implementation or enhancement of evidence-based interventions and other program components. The analysis, conducted in 2020, used ordinary least square and generalized estimating equations regressions and first difference models to estimate the associations of independent variables with the outcome.
Of the total 336 clinics, 50%-70% newly implemented or enhanced different evidence-based interventions. Among these, client reminders were most highly associated with the increase in screening rates (8.0 percentage points). Provider reminder was not significantly associated with any change in screening rates. Among all program components, having a colorectal cancer screening champion was most highly (8.4 percentage points) associated with screening rate change. Results from different models were slightly different but in agreement.
Client reminders, provider assessment and feedback, and colorectal cancer screening champions were associated with increased clinic-level colorectal cancer screening rates. Universal implementation of these strategies can substantially increase colorectal cancer screening rates in the U.S.
疾病控制与预防中心管理结直肠癌防控计划，以提高 50-75 岁人群的结直肠癌筛查率，这些人群所在地区的结直肠癌筛查率低于州或国家水平。本研究旨在更好地了解特定结直肠癌防控计划组成部分的有效性。
研究人群包括在第 1 年和第 2 年参与结直肠癌防控计划的诊所。疾病预防控制中心每年从 2015 年到 2017 年收集的用于计划评估的诊所数据被用于本研究。结果变量是到项目第 2 年的筛查率变化，预测变量是新实施或增强的基于证据的干预措施和其他项目组成部分。分析于 2020 年进行，使用普通最小二乘法和广义估计方程回归以及一阶差分模型来估计独立变量与结果之间的关联。
在总共 336 家诊所中，有 50%-70%的诊所新实施或增强了不同的基于证据的干预措施。在这些诊所中，患者提醒与筛查率的增加最相关（8.0 个百分点）。提供者提醒与筛查率的任何变化均无显著关联。在所有项目组成部分中，拥有结直肠癌筛查冠军与筛查率变化的相关性最高（8.4 个百分点）。来自不同模型的结果略有不同，但一致。
患者提醒、提供者评估和反馈以及结直肠癌筛查冠军与增加诊所层面的结直肠癌筛查率相关。这些策略的普遍实施可以在美国显著提高结直肠癌的筛查率。
