Ameen Saleem, Wong Ming Chao, Turner Paul, Yee Kwang Chien
College of Health and Medicine, University of Tasmania, Hobart 7000, Tasmania, Australia.
College of Sciences and Engineering, University of Tasmania, Hobart 7000, Tasmania, Australia.
Clin Res Hepatol Gastroenterol. 2023 Jan;47(1):102064. doi: 10.1016/j.clinre.2022.102064. Epub 2022 Dec 7.
The current "Gold Standard" colorectal cancer (CRC) screening approach of faecal occult blood test (FOBT) with follow-up colonoscopy has been shown to significantly improve morbidity and mortality, by enabling the early detection of disease. However, its efficacy is predicated on high levels of population participation in screening. Several international studies have shown continued low rates of screening participation, especially amongst highly vulnerable lower socio-economic cohorts, with minimal improvement using current recruitment strategies. Research suggests that a complex of dynamic factors (patient, clinician, and the broader health system) contribute to low citizen engagement. This paper argues that the challenges of screening participation can be better addressed by (1) developing dynamic multifaceted technological interventions collaboratively across stakeholders using human-centered design; (2) integrating consumer-centred artificial intelligence (AI) technologies to maximise ease of use for CRC screening; and (3) tailored strategies that maximise population screening engagement, especially amongst the most vulnerable.
目前,粪便潜血试验(FOBT)结合后续结肠镜检查的“金标准”结直肠癌(CRC)筛查方法已被证明能够通过早期发现疾病显著降低发病率和死亡率。然而,其效果取决于高比例的人群参与筛查。多项国际研究表明,筛查参与率持续较低,尤其是在社会经济地位较低的弱势群体中,采用当前的招募策略后改善甚微。研究表明,一系列动态因素(患者、临床医生和更广泛的卫生系统)导致了民众参与度较低。本文认为,可以通过以下方式更好地应对筛查参与方面的挑战:(1)采用以人为本的设计方法,跨利益相关者合作开发动态多维度技术干预措施;(2)整合以消费者为中心的人工智能(AI)技术,以最大程度地提高CRC筛查的易用性;(3)制定有针对性的策略,以最大程度地提高人群筛查参与度,特别是在最弱势群体中。