Enhancing CRC Screening in a Predominantly Hispanic Community: Effectiveness of 1-Day vs. 3-Day Stool-Based Testing Kits.

IF 3.9 3区 医学 Q1 HEALTH POLICY & SERVICES Journal of Community Health Pub Date : 2025-02-01 Epub Date: 2024-09-06 DOI:10.1007/s10900-024-01394-x
Jonathan D Wing, Pracheta Matharasi, Alok Dwivedi, Jennifer Molokwu
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Abstract

Colorectal cancer (CRC) is the leading cause of cancer-related mortality among U.S. Hispanics, with screening proven to decrease both incidence and mortality. Despite rising CRC screening rates in the U.S., Hispanic participation remains disproportionately low. Stool-based tests, particularly popular for reaching underserved populations, may enhance screening adherence. This study evaluates the performance of a 1-day versus a 3-day stool-based testing kit in improving screening completion rates and reducing the need for reminder calls in a Hispanic community along the U.S.-Mexico border. In our quasi-experimental observational study, participants aged 45-75 years who were uninsured or underinsured and overdue for CRC screening were recruited. They received colorectal cancer education and no-cost stool-based screening facilitated by promotoras. Participants were randomly assigned to receive a 1-day or 3-day Fecal Immunochemical Test (FIT) kit. The promotoras swapped FIT kit distribution roles midway through the study period to mitigate performance bias. Our analysis covered 6,660 FITs-3,067 using the 3-day kit and 3,593 with the 1-day kit. Results indicated a higher return rate for the 1-day FIT kit (61.3% vs. 58.7%, adjusted odds ratio [aOR] = 1.22, p < 0.001), fewer reminders needed (69.7% vs. 78.1%, aOR = 0.65, p < 0.001), and lower abnormal FIT results (5.3% vs. 8.1%, aOR = 0.61, p < 0.001). Conclusively, the 1-day FIT kit required fewer reminders and significantly improved return rates, suggesting it may be a more effective option for increasing CRC screening completion among hard-to-reach Hispanic populations.

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在以西班牙裔为主的社区加强儿童癌症筛查:1天与3天粪便检测试剂盒的效果对比。
结肠直肠癌 (CRC) 是导致美国西班牙裔癌症相关死亡的主要原因,而筛查已被证明可以降低发病率和死亡率。尽管美国的 CRC 筛查率在不断上升,但西班牙裔的参与率仍然低得不成比例。以粪便为基础的检测方法尤其受服务不足人群的欢迎,可提高筛查的依从性。本研究评估了在美墨边境的西班牙裔社区中,1 天粪便检测试剂盒与 3 天粪便检测试剂盒在提高筛查完成率和减少提醒电话需求方面的性能。在我们的准实验观察研究中,我们招募了年龄在 45-75 岁之间、无保险或保险不足且逾期未接受 CRC 筛查的参与者。他们在宣传员的协助下接受了结直肠癌教育和免费粪便筛查。参与者被随机分配接受为期 1 天或 3 天的粪便免疫化学检验 (FIT) 套件。在研究期间,宣传员中途交换了 FIT 套件的分发角色,以减少绩效偏差。我们的分析涵盖了 6,660 次 FIT,其中 3,067 次使用 3 天试剂盒,3,593 次使用 1 天试剂盒。结果显示,1 天 FIT 套件的返回率更高(61.3% 对 58.7%,调整赔率 [aOR] = 1.22,p
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来源期刊
CiteScore
10.80
自引率
1.70%
发文量
113
期刊介绍: The Journal of Community Health is a peer-reviewed publication that offers original articles on research, teaching, and the practice of community health and public health. Coverage includes public health, epidemiology, preventive medicine, health promotion, disease prevention, environmental and occupational health, health policy and management, and health disparities. The Journal does not publish articles on clinical medicine. Serving as a forum for the exchange of ideas, the Journal features articles on research that serve the educational needs of public and community health personnel.
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