Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Public Health. 2024 Oct;235:194-201. doi: 10.1016/j.puhe.2024.07.003. Epub 2024 Aug 16.
Access to health services has received increasing attention, and the International Agency for Research on Cancer (IARC) includes 'availability' as one of the indicators to evaluate cancer screening. Evaluating, monitoring, and decision-making on cancer screening depends on systematic quantitative evidence on access to cancer screening, but indicators are currently inconsistently, if they are reported at all. This can be improved by developing systematic indicators for evaluating and reporting access to cancer screening. This requires a thorough understanding of current indicators of access to cancer screening.
Scoping review.
We completed a scoping review of studies on access to cancer screening services from 2013 to 2022. The relevant indicators were extracted, quantified, and then matched to two widely used frameworks: a universal five-dimensional conceptual framework for access to healthcare ('U5D') and a cancer-specific framework/list on the availability/use of screening indicators endorsed by the IARC.
A total of 331 studies on access to cancer screening services were included. Based on the U5D framework, publications from supply side reported approachability (number of publications = 16), acceptability (6), availability and accommodation (44), affordability (30), and appropriateness (11); among this process, 17 sub-indicators were identified. Correspondingly, publications from demand side reported ability to perceive (170), ability to seek (85), ability to reach (58), ability to pay (59), and ability to engage (2); 26 sub-indicators were identified. More macroscopically, the publications of the IARC-endorsed indicators reported availability of policies and guidelines for screening (13), type of screening provided (3), extent of population coverage and participation rates (76), and demographic/behavioural related considerations (167). By integrating the universal and cancer-specific frameworks, a new adapted framework was proposed.
This study identified and collated indicators for evaluating access to cancer screening services, and determined the gaps in the current application of various indicators. The findings are anticipated to facilitate further development of an evaluation indicator system for access to cancer screening services.
人们越来越关注获得卫生服务的问题，国际癌症研究机构（IARC）将“可及性”作为评估癌症筛查的指标之一。癌症筛查的评估、监测和决策取决于关于癌症筛查可及性的系统定量证据，但目前这些指标的报告并不一致，如果有报告的话。通过开发评估和报告癌症筛查可及性的系统指标，可以对此加以改善。这需要对当前评估癌症筛查可及性的指标有一个透彻的了解。
范围综述。
我们对 2013 年至 2022 年期间关于癌症筛查服务可及性的研究进行了范围综述。提取、量化了相关指标，并将其与两个广泛使用的框架相匹配：一个是普遍的医疗保健获取的五维度概念框架（U5D），另一个是 IARC 认可的用于评估癌症筛查可用性/使用的特定于癌症的框架/清单。
共纳入 331 项关于癌症筛查服务可及性的研究。根据 U5D 框架，来自供应方的出版物报告了可达性（出版物数量为 16）、可接受性（6）、可用性和适应性（44）、可负担性（30）和适宜性（11）；在这一过程中，确定了 17 个次指标。相应地，来自需求方的出版物报告了感知能力（170）、寻求能力（85）、到达能力（58）、支付能力（59）和参与能力（2）；确定了 26 个次指标。更宏观地看，IARC 认可的指标的出版物报告了筛查政策和指南的可用性（13）、提供的筛查类型（3）、人口覆盖率和参与率（76）以及人口统计学/行为相关考虑因素（167）。通过整合通用和癌症特定框架，提出了一个新的适应框架。
本研究确定并整理了评估癌症筛查服务可及性的指标，并确定了当前各种指标应用中的差距。研究结果有望促进进一步开发癌症筛查服务可及性评估指标体系。
