英国风险分层型肠癌筛查的公众可接受性及预期参与情况：一项在线调查
Public acceptability and anticipated uptake of risk-stratified bowel cancer screening in the UK: An online survey.
作者信息
Taylor Lily C, Dennison Rebecca A, Usher-Smith Juliet A
机构信息
The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
出版信息
Prev Med Rep. 2024 Nov 10;48:102927. doi: 10.1016/j.pmedr.2024.102927. eCollection 2024 Dec.
OBJECTIVE
This study aimed to quantify public acceptability and anticipated uptake with risk stratification incorporated at three points on the bowel cancer screening pathway, compared with current screening in England.
METHODS
We conducted an online population-based survey of 1,203 UK adults in 2024. The main outcome measures were overall acceptability of three strategies where risk stratification is introduced at 1) the point of eligibility, 2) the referral threshold and 3) the screening interval, compared with the current programme (screening as usual), and the acceptability of high- and low-risk screening practices at each point. Other outcomes included anticipated uptake of screening and the acceptability of data collection methods.
RESULTS
Acceptability of risk-stratified eligibility and referral thresholds was significantly greater than for screening as usual ( < 0.001). There was no difference for stratified intervals. At all three points, more intense screening for those at high-risk was more acceptable and less intense screening for those at low-risk less acceptable when compared with screening as usual ( < 0.0001). The anticipated likelihood of taking up screening was also significantly higher if at high-risk and significantly lower if at low-risk, compared with screening as usual for all strategies ( < 0.0001).
CONCLUSIONS
Participants expressed strong acceptability for risk-stratified bowel cancer screening, particularly for risk-stratified eligibility and thresholds for referral. However, acceptability for less intense screening for those at low-risk was lower than for the current programme and may negatively impact uptake. This suggests that the design and framing of risk groups requires careful consideration and communication with the public.
PATIENT AND PUBLIC CONTRIBUTION
Three members of the public contributed through online correspondence to the development of the survey and participant-facing documents.
目的
本研究旨在量化在肠癌筛查路径中的三个点纳入风险分层时公众的可接受性和预期参与度，并与英国目前的筛查情况进行比较。
方法
2024年，我们对1203名英国成年人进行了一项基于人群的在线调查。主要结局指标是三种策略的总体可接受性，这三种策略分别是在以下三个点引入风险分层：1）资格认定点；2）转诊阈值点；3）筛查间隔点，将其与当前项目（常规筛查）进行比较，以及每个点上高风险和低风险筛查做法的可接受性。其他结局包括筛查的预期参与度和数据收集方法的可接受性。
结果
风险分层的资格认定和转诊阈值的可接受性显著高于常规筛查（<0.001）。分层间隔方面没有差异。与常规筛查相比，在所有三个点上，对高风险人群进行更密集的筛查更易被接受，而对低风险人群进行强度较低的筛查则较难被接受（<0.0001）。与所有策略的常规筛查相比，高风险人群接受筛查的预期可能性也显著更高，低风险人群则显著更低（<0.0001）。
结论
参与者对风险分层的肠癌筛查表示出强烈的可接受性，特别是对风险分层的资格认定和转诊阈值。然而，对低风险人群进行强度较低筛查的可接受性低于当前项目，可能会对参与度产生负面影响。这表明风险组的设计和框架需要仔细考虑并与公众进行沟通。
患者和公众参与
三名公众通过在线通信为调查和面向参与者的文件的制定做出了贡献。
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