電話語音通知可提升大腸直腸癌首篩族群的篩檢率：全市介入研究

Telephone Notifications Improve Colorectal Cancer Screening Rates in Naïve Screening Population:A Citywide Study

目的：自2004年起，台灣開始了全國性的大腸直腸癌（CRC）篩檢計畫，50至74歲成人每兩年可接受一次糞便潛血檢查（FOBT）；然而，大腸直腸癌篩檢率至今仍然偏低。為了提升大腸直腸癌篩檢率，本研究針對全台北市首次接受大腸直腸癌篩檢的族群，探討以電話語音通知介入對提高大腸直腸癌篩檢率的效果。
方法：直至2017年，所有年滿50歲、具台灣全民健康保險資格且生平第一次接受糞便潛血檢查的台北市民（也就是所謂的首篩族群）都被納入此研究的研究對象。介入組會接到第一次的電話語音通知提醒接受大腸直腸癌篩檢；接著進一步被分成兩個次組，其中一個次組在完成第一次篩檢通知後會再由公共衛生護理師進行一對一電話諮詢，即為第二次大腸直腸癌篩檢通知。對照組則包括無法取得電話號碼的首篩市民或未完成第一次通知的研究對象。
結果：在39，302名首篩族群中，介入組共有16，812人完成電話語音通知，介入組的大腸直腸癌篩檢率顯著高於對照組（17.0％vs.7.5％）；其中，進一步接受一對一電話諮詢的14，733名首篩族群的篩檢率則更高（17.7％）。此外，介入組從通知到接受篩檢的時間間隔也較對照組短。
結論：電話語音通知能有效提升大腸直腸癌首次篩檢族群的篩檢率，如果進一步結合一對一電話諮詢介入，篩檢率的提升效果會更為顯著。

Purpose: A nationwide biennial screening program using fecal occult blood test (FOBT) for adults aged 50-74 was enacted in Taiwan since 2004. However, the colorectal cancer (CRC) screening rate was still low. We conducted this citywide program targeting the naïve screening population and reported the effects of notifying phone calls on improving CRC screening rates.
Methods: All Taipei citizens aged 50 by 2017 eligible to receive their first FOBT (the naïve population) were enrolled. The intervention group accomplished the 1st CRC screening notification via notifying phone calls and were further subdivided into two subgroups. One subgroup received the 2nd notification with one-on-one phone counselling by public health nurses. The control group included those who had no available phone numbers or failed the 1st notification.
Results: Of the 39,302 naïve screenees, 16,812 received the notifying phone calls. The CRC screening rate was higher in the intervention than in the control group (17.0% vs. 7.5%). The subgroup of 14,733 participants having one-on-one phone counselling showed an even higher rate (17.7%). The interval between notification and screening date was shorter in the intervention group.
Conclusion: Telephone notifications improved CRC screening in naive screenees and were more effective when combined with one-on-one phone counselling.