基于血液的结直肠癌筛查:在两家阿巴拉契亚初级保健诊所的实施情况。
Blood-Based Colorectal Cancer Screening: Implementation Into 2 Appalachian Primary Care Clinics.
作者信息
Haynes William B, Talari Mridula P, Elmore Karen A, Jastan Rasmiyah M, Resil Julia J L
机构信息
Johnston Memorial Hospital Residency Program, Ballad Health, Johnson City, Tennessee.
Johnston Memorial Hospital Residency Program, Ballad Health, Johnson City, Tennessee; Hematology and Medical Oncology, University of Missouri School of Medicine, Columbia, Missouri.
出版信息
Am J Prev Med. 2025 Jul;69(1):107636. doi: 10.1016/j.amepre.2025.04.006. Epub 2025 Apr 17.
INTRODUCTION
Colorectal cancer is a serious health concern in the U.S. and worldwide and the third leading cause of cancer mortality. Appalachia ranks low in screening for colorectal cancer and correspondingly higher in incident and mortality rates than other regions of the U.S. This study aimed to determine whether offering a blood-based test to screen for colorectal cancer would result in increased rates of screening for colorectal cancer.
METHODS
Colorectal cancer screening rates were measured in 2 primary care clinics over two 3-month phases. In Phase 1, physicians conducted colorectal cancer screening with standard-of-care options only (n=74). Phase 2 differed by offering blood-based test along with standard-of-care options (n=165). The study objective was to see whether offering a blood-based test would (1) increase the overall rate of screening and (2) prove to be a preferred method of screening compared with standard-of-care options. Data were gathered and evaluated in 2024.
RESULTS
There was a large observed increase in overall completed screening rates when comparing Phase 1 (n=33) with Phase 2 (n=151). In addition, in Phase 2, the blood-based test option was a strong preference to standard of care (standard of care, n=29; blood-based test, n=134) with this sample group.
CONCLUSIONS
The availability of a blood-based test as one option for routine colorectal cancer screening in adults with average risk for colorectal cancer had a clear positive impact on overall screening rates, completion rates, and patient preference to standard-of-care options.
引言
结直肠癌在美国和全球都是一个严重的健康问题,是癌症死亡的第三大主要原因。阿巴拉契亚地区在结直肠癌筛查方面排名较低,因此其发病率和死亡率相应高于美国其他地区。本研究旨在确定提供一种基于血液的检测方法来筛查结直肠癌是否会提高结直肠癌的筛查率。
方法
在两个为期3个月的阶段中,对两家初级保健诊所的结直肠癌筛查率进行了测量。在第1阶段,医生仅采用标准护理方案进行结直肠癌筛查(n = 74)。第2阶段的不同之处在于,除了标准护理方案外,还提供基于血液的检测(n = 165)。研究目的是观察提供基于血液的检测是否会(1)提高总体筛查率,以及(2)被证明是一种比标准护理方案更受青睐的筛查方法。数据于2024年收集和评估。
结果
将第1阶段(n = 33)与第2阶段(n = 151)进行比较时,观察到总体完成筛查率有大幅提高。此外,在第2阶段,对于该样本组,基于血液的检测方案比标准护理方案更受青睐(标准护理方案,n = 29;基于血液的检测,n = 134)。
结论
对于结直肠癌平均风险的成年人,将基于血液的检测作为常规结直肠癌筛查的一种选择,对总体筛查率、完成率以及患者对标准护理方案的偏好产生了明显的积极影响。