描述
Structural barriers are non-economic burdens or obstacles that make it difficult for people to access cancer screening. Interventions designed to reduce these barriers may facilitate access to cancer screening services by:
• Reducing time or distance between service delivery settings and target populations
• Modifying hours of service to meet client needs
• Offering services in alternative or non-clinical settings (e.g., mobile mammography vans at worksites or in residential communities)
• Eliminating or simplifying administrative procedures and other obstacles (e.g., 调度援助, 病人的航海家, 运输, 依赖护理, 翻译服务, 限制就诊次数)
The 社区 Preventive Services Task Force recommends interventions to reduce structural barriers to increase screening for breast and colorectal cancers (by mammography and FOBT, respectively) on the basis of strong evidence of effectiveness. 证据是不够的, 然而, to determine whether reducing structural barriers is effective in increasing colorectal cancer screening by flexible sigmoidoscopy or colonoscopy because only one study using these screening procedures were identified. Evidence is also insufficient to determine the effectiveness of the intervention in increasing screening for cervical cancer because only three relevant studies were identified, and these had some methodological limitations.
影响
Interventions to reduce structural barriers can increase cancer screenings.
结果/成就
系统评价的结果:
乳腺癌:
原评审结果
The original breast cancer screening review included seven studies.
• Mammography screening: median increase of 17.7 percentage points (interquartile interval [IQI]: 11.5 to 30.5个基点).
更新评审结果
One additional study qualified for the updated review.
• Mammography screening: increase of 18 percentage points
Clinical breast examinations: increase of 34 percentage points
宫颈癌:
有三项研究符合审查条件.
•巴氏筛查:中位数增加13.6个百分点(范围:5.9-17.8)
•While these results were in the favorable direction, the studies had some methodological limitations.
结直肠癌:
原评审结果
The original colorectal cancer screening review included seven studies.
• Screening by FOBT: median increase of 16.(IQI: 12.1 to 22.9个基点)
更新评审结果
Five additional studies qualified for the updated review.
•Colorectal cancer screening: median increase of 36.9个百分点(范围:16个百分点.3 to 41.1 percentage points; 4 study arms)
•The larger intervention effect during the update period imay be at least partially due to differences in target populations, 基线筛查率, 和研究设计.
•The Task Force recommendation should be applicable across a range of settings where target populations may have limited physical access to FOBT.
关于这个有前途的实践
主要联络
主题
健康/癌症
Source
社区 Guide Branch Epidemiology and Analysis Program Office, Centers for Disease Control and Prevention
位置
美国
为更多的细节
目标受众
成年人
Related Content for: 疾病预防控制中心社区指南:癌症预防 & Control, Client-Oriented Screening Interventions: Reducing Structural Barriers: Breast Cancer
