Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, UK.
Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, UK.
Lancet Oncol. 2024 Aug;25(8):e388-e395. doi: 10.1016/S1470-2045(24)00102-5. Epub 2024 Jun 4.
Improving cancer outcomes through innovative cancer detection initiatives in primary care is an international policy priority. There are unique implementation challenges to the roll-out and scale-up of different innovations, requiring synchronisation between national policy levers and local implementation strategies. We draw on implementation science to highlight key considerations when seeking to sustainably embed cancer detection initiatives within health systems and clinical practice. Points of action include considering the implications of change on the current configuration of responsibility for detecting cancer; investing in understanding how to adapt systems to support innovations; developing strategies to address inequity when planning innovation implementation; and anticipating and making efforts to mitigate the unintended consequences of innovation. We draw on examples of contemporary cancer detection issues to illustrate how to apply these recommendations to practice.
通过在初级保健中开展创新的癌症检测举措来改善癌症预后是一项国际政策重点。不同创新举措的推出和扩大存在独特的实施挑战，需要在国家政策杠杆和地方实施策略之间进行同步。我们借鉴实施科学，重点强调在寻求将癌症检测举措可持续地嵌入卫生系统和临床实践时需要考虑的关键因素。行动要点包括考虑变革对当前癌症检测责任配置的影响；投资于了解如何调整系统以支持创新；制定策略解决创新实施过程中的不平等问题；以及预测和努力减轻创新的意外后果。我们借鉴当代癌症检测问题的实例来说明如何将这些建议应用于实践。
