PO.CL04.02 · 临床研究
在一项干预试验中阿拉斯加原住民未完成结直肠癌筛查的情况
Non-completion of colorectal cancer screening among Alaska Native people in an intervention trial
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：阿拉斯加部落卫生系统正在努力提高阿拉斯加原住民的结直肠癌(CRC)筛查率。目前尚不清楚为什么最初同意接受筛查的人可能不会坚持完成筛查。
方法：作为一项研究多靶点粪便DNA(mt-sDNA)检测在阿拉斯加农村社区应用的更大规模干预的一部分，我们访谈了那些曾同意安排结肠镜检查或同意将mt-sDNA试剂盒寄到家中、但未完成其所选检测的阿拉斯加原住民。
结果：在531名最初同意但未完成筛查的阿拉斯加原住民中，299名(56%)能够联系上进行后续调查。其中，256名(86%)回答了调查问卷；选择mt-sDNA者中有187/224(83%)，选择结肠镜检查者中有69/75(93%)。粪便DNA检测试剂盒未完成的原因包括忙碌或遗忘、对进行粪便检测感到不适、不知道如何进行检测或对如何寄回试剂盒进行处理存在顾虑。结肠镜检查未完成的原因包括排期问题、身体健康问题、交通以及住房障碍，还有费用、恐惧和过于忙碌。值得注意的是，两组中许多受访者表示他们将来仍有兴趣进行CRC筛查，或者目前正在寻求筛查。
结论：这是首次探讨阿拉斯加原住民在初次提出检测请求后未能坚持CRC筛查的原因。所识别出的许多主题都可以通过医疗保健系统的改变加以解决，以便未来的干预措施改善筛查外展和参与度。
查看英文原文 English abstract
Background: The Alaska Tribal Health System is working to increase colorectal cancer (CRC) screening among Alaska Native peoples. It is unknown why people who initially agree to screening might not follow through to complete their screening.
Methods: As part of a larger intervention investigating multi-target stool DNA (mt-sDNA) test use in rural Alaska communities, we interviewed Alaska Native people who had agreed to scheduling a colonoscopy or having a mt-sDNA kit sent to their home but who did not complete their selected test.
Results: Of 531 Alaska Native people who initially agreed but did not complete screening, 299 (56%) were able to be contacted for a follow-up survey. Of those, 256 (86%) answered the survey; 187/224 (83%) who had chosen mt-sDNA, and 69/75 (93%) who had chosen colonoscopy. Reported reasons for non-completion of stool DNA test kits included being busy or forgetting, being uncomfortable doing a stool test, and not knowing how to do the test or concerns over how to return the kit for processing. Reasons for non-completion of colonoscopy included scheduling issues, physical health issues, travel, and housing barriers, as well as cost, fear, and being too busy. Of note, many respondents in both groups indicated they would still be interested in CRC screening in the future or were currently pursuing screening.
Conclusions: This was the first exploration of reasons for non-adherence to CRC screening after initial test request by Alaska Native people. Many of the identified themes are amenable to health care system changes for future interventions to improve screening outreach and uptake.
利益披露 Disclosure
D. Redwood, None..
L. Jeffries, None..
M. Toffolon, None..
J. Klejka, None.