Kobrin Sarah, Subramanian Sujha, Hoover Sonja, McCarthy Sharon, Castañeda Sheila F, Mishra Shiraz I
National Cancer Institute, Rockville, MD, USA.
Implenomics, Dover, DE, USA.
Health Educ Behav. 2025 Jul 11:10901981251346803. doi: 10.1177/10901981251346803.
Increasing colorectal cancer (CRC) screening requires delivery and adaptation of evidence-based and theory-guided interventions. The Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science (ACCSIS) consortium is funded by the National Cancer Institute, with a primary goal of increasing the availability and use of approaches to CRC prevention and control, from screening through follow-up testing, diagnosis, and referral to care. In this article, we present a framework for improving CRC, follow-up, and referral to care among populations that have low CRC screening rates. We used a multistep, consensus- and data-driven approach to develop the ACCSIS framework. Eight collaborating Research Projects of the ACCSIS consortium evaluated the draft; they provided feedback in relation to their study designs, settings, populations, and methods. They also used evaluation results to refine the framework until they reached consensus. The current framework reflects common elements, expected intervention and screening outcomes, and is intended to contribute to future ACCSIS analyses and others' intervention and research plans. The framework recognizes the iterative nature of CRC screening programs and emphasizes multiple levels of influence-from baseline factors affecting selection of intervention components through measurement of process, screening, and implementation outcomes. Future researchers and practitioners can adapt the ACCSIS framework to advance CRC screening and to improve other cancer prevention and control research and practices that have created and perpetuated health disparities.
增加结直肠癌（CRC）筛查需要提供并调整基于证据和理论指导的干预措施。通过实施科学加速结直肠癌筛查与随访（ACCSIS）联盟由美国国立癌症研究所资助，其主要目标是提高从筛查到后续检测、诊断以及转诊治疗等结直肠癌预防和控制方法的可及性和使用率。在本文中，我们提出了一个框架，用于改善结直肠癌筛查率较低人群的结直肠癌筛查、随访及转诊治疗情况。我们采用了多步骤、基于共识和数据驱动的方法来制定ACCSIS框架。ACCSIS联盟的八个合作研究项目对该框架草案进行了评估；它们根据各自的研究设计、环境、人群和方法提供了反馈。他们还利用评估结果对框架进行完善，直至达成共识。当前的框架反映了共同要素、预期的干预和筛查结果，旨在为未来的ACCSIS分析以及其他机构的干预和研究计划做出贡献。该框架认识到结直肠癌筛查项目的迭代性质，并强调从影响干预措施组成部分选择的基线因素到过程、筛查和实施结果测量等多个层面的影响。未来的研究人员和从业者可以调整ACCSIS框架，以推进结直肠癌筛查，并改善其他造成和延续健康差距的癌症预防和控制研究及实践。
