免费诊所中的结直肠癌筛查：系统评价。

Colorectal Cancer Screening in Free Clinics: A Systematic Review.

出版信息

J Health Care Poor Underserved. 2024;35(2):425-438.

Abstract

OBJECTIVE

There are significant inequities in colorectal cancer (CRC) screening and outcomes. Via literature review, we assessed CRC screening rates for the vulnerable populations served by free clinics.

METHODS

A systematic review was conducted for publications on CRC screening in free clinics. Outcomes included CRC screening characteristics, population demographics, and limitations. A methodological quality assessment was completed.

RESULTS

Out of 63 references, six studies were included, representing 8,844 participants. Black or Hispanic participants were the plurality in all but one study. All participants were uninsured. Median CRC screening rate was 48.4% (range 6.6-78.9%). Screening methods included colonoscopy, fecal occult blood test, flexible sigmoidoscopy, and fecal immunochemical test. Clinics offering only one screening method had a mean screening rate of 7.2% while those with multiple methods had a screening rate of 65.4%.

CONCLUSION

Access to multiple CRC screening modalities correlates with higher screening rates in free clinics. More work is needed to increase CRC screening in free clinics.

摘要

目的

结直肠癌（CRC）筛查和结果存在显著的不平等。通过文献回顾，我们评估了为免费诊所服务的弱势群体的 CRC 筛查率。

方法

对免费诊所的 CRC 筛查相关文献进行了系统评价。研究结果包括 CRC 筛查的特点、人口统计学特征和局限性。同时完成了方法学质量评估。

结果

在 63 篇参考文献中，有 6 项研究被纳入，共涉及 8844 名参与者。除了一项研究外，其余研究中的参与者均为黑人和/或西班牙裔，且均无保险。CRC 筛查的中位数为 48.4%（范围为 6.6-78.9%）。筛查方法包括结肠镜检查、粪便隐血试验、乙状结肠镜检查和粪便免疫化学试验。仅提供一种筛查方法的诊所的平均筛查率为 7.2%，而提供多种筛查方法的诊所的筛查率为 65.4%。