患者导航对基于人群的乳腺癌筛查的影响：随机临床试验的系统评价和荟萃分析。

Impact of Patient Navigation on Population-Based Breast Screening: a Systematic Review and Meta-analysis of Randomized Clinical Trials.

机构信息

The Third Central Clinical College of Tianjin Medical University, Tianjin, 300170, China.

Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China.

出版信息

J Gen Intern Med. 2022 Aug;37(11):2811-2820. doi: 10.1007/s11606-022-07641-y. Epub 2022 Jun 1.

BACKGROUND

Unsatisfactory cancer screening results are often associated with poor prognosis. This study synthesized the literatures addressing the impact of patient navigation (PN) interventions on population-based breast cancer screening promotion to identify characteristics of the model for addressing breast cancer disparities.

METHODS

We searched Pubmed, Embase, Web of Science, and the Cochrane Central Registry from inception to 31 December 2020 for randomized controlled trials (PROSPERO: CRD42021246890). We double blindly abstracted data and assessed study quality. We assessed screening completion rates and diagnostic resolution using random-effects models between those receiving navigation and controls.

RESULTS

Of 236 abstracts identified, 15 studies met inclusion criteria. Nine of the papers evaluated the impact of PN on breast screening, while the other six were on the resolution of abnormal screening results. Compared to the non-PN group, PN improved screening completion (OR: 2.0, 95% CI: 1.4-2.8]) and shortened the time to diagnosis (WMD: - 9.90 days, 95% CI: - 19.09 to - 0.71).

CONCLUSIONS

Patient navigation improves breast cancer screening rates but does not improve resolution of abnormal tests.

背景

令人不满意的癌症筛查结果通常与预后不良有关。本研究综合了有关患者导航（PN）干预对基于人群的乳腺癌筛查促进影响的文献，以确定解决乳腺癌差异模型的特征。

方法

我们从成立到 2020 年 12 月 31 日在 Pubmed、Embase、Web of Science 和 Cochrane 中央登记处搜索了随机对照试验（PROSPERO：CRD42021246890）。我们对数据进行了双盲摘要，并评估了研究质量。我们使用随机效应模型评估了接受导航和对照组之间的筛查完成率和诊断分辨率。

结果

在 236 篇摘要中，有 15 项研究符合纳入标准。其中 9 篇论文评估了 PN 对乳腺癌筛查的影响，另外 6 篇论文评估了异常筛查结果的分辨率。与非 PN 组相比，PN 提高了筛查完成率（OR：2.0，95%CI：1.4-2.8]），并缩短了诊断时间（WMD：-9.90 天，95%CI：-19.09 至-0.71）。