哪些因素会影响肠癌、乳腺癌和宫颈癌筛查的接受率?一项国际研究综述。
What factors influence the uptake of bowel, breast and cervical cancer screening? An overview of international research.
作者信息
Prowse Sarah R, Brazzelli Miriam, Treweek Shaun
机构信息
Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom.
出版信息
Eur J Public Health. 2024 Aug 1;34(4):818-825. doi: 10.1093/eurpub/ckae073.
BACKGROUND
For cancer screening programmes to be effective in early detection it is important that those invited can access screening services and understand the benefits of participation. A better understanding of the factors that matter to potential participants of cancer screening programmes can assist in developing strategies to increase current uptake.
METHODS
We conducted an overview of systematic reviews to answer the question: What factors influence the uptake of cancer screening services (breast, bowel and cervical) in high-income countries? A thematic approach supported by tabular summaries and qualitative heat maps was used to categorize factors, described as 'barriers' or 'facilitators'.
RESULTS
A total of 41 systematic reviews met the criteria for inclusion. The barrier with the greatest number of 'hot spots' across all three screening programmes was a fear of the unknown regarding a possible diagnosis of cancer or abnormal screening results, followed closely by a general lack of knowledge surrounding cancer screening programmes. The greatest collective facilitator to uptake was recommendation by a healthcare provider to attend screening.
CONCLUSION
Across all factors 'trust' and 'building trusted relationships' can be seen as integral to the success of cancer screening programmes and must be reflective of collaborative efforts to mitigate barriers and enhance facilitators to uptake. There is future scope to consider interventions that (i) increase demand for screening services, (ii) reduce barriers to uptake of services and/or (iii) are relevant to the healthcare system and those providing services.
背景
为使癌症筛查项目在早期检测中发挥有效作用,重要的是受邀者能够获得筛查服务并了解参与的益处。更好地理解对癌症筛查项目潜在参与者重要的因素,有助于制定提高当前参与率的策略。
方法
我们对系统评价进行了综述,以回答以下问题:在高收入国家,哪些因素影响癌症筛查服务(乳腺癌、肠癌和宫颈癌)的参与率?采用一种由表格总结和定性热图支持的主题方法对因素进行分类,这些因素被描述为“障碍”或“促进因素”。
结果
共有41项系统评价符合纳入标准。在所有三项筛查项目中,“热点”数量最多的障碍是对癌症可能诊断或异常筛查结果的未知恐惧,紧随其后的是对癌症筛查项目普遍缺乏了解。参与的最大共同促进因素是医疗保健提供者建议参加筛查。
结论
在所有因素中,“信任”和“建立信任关系”可被视为癌症筛查项目成功的不可或缺因素,并且必须反映出为减轻障碍和增强参与促进因素而做出的共同努力。未来有空间考虑采取以下干预措施:(i)增加对筛查服务的需求,(ii)减少服务参与障碍和/或(iii)与医疗保健系统及提供服务者相关的措施。