从社区实践到公共卫生政策——“上海社区居民大肠癌筛查”项目的规划和实施

From community practice to public health policy——planning and implementation of Shanghai colorectal cancer screening program

人群筛查可以降低大肠癌的死亡率,是控制大肠癌疾病负担的有效措施。人群筛查策略的制定和实施是区域性癌症控制规划的重要内容。上海于2011年将"社区居民大肠癌筛查"列入重大公共卫生服务项目,接着,原市卫生局等机构联合下发了《关于组织开展本市重大公共卫生服务项目"上海市社区居民大肠癌筛查"的通知》,在全市范围向符合条件的居民免费提供大肠癌筛查服务。通过科学论证和反复实践,上海在全国率先将一项成熟的癌症筛查措施纳入公共卫生服务,是我国大规模人群癌症筛查在公共卫生政策上一大突破。本文回顾了该项目从设计、社区试点到形成公共卫生政策而在全市推广的历程,讨论了大肠癌筛查从技术措施转化为公共卫生服务项目,并在人群中推广实施过程中,如何应用循证的方法解决相关技术性和实施性问题。

Population-based screening can reduce the mortality of colorectal cancer { CRC } and is an effective intervention to control the burden of CRC. Establishment and implementation of population-based screening strategies are important for regional cancer control planning Government launched ＂Shanghai Colorectal Cancer Screening Program＂ In 2011, Shanghai Municipal as one of the municipal major public health service projects, and then the former Shanghai Municipal Health Bureau issued Notice to organize the implementation of the i, Shanghai Colorectal Cancer Screening Program＂ as one of the municipal major public health service projects and provided free CRC screening services for qualified residents across the whole city of Shanghai. By means of scientific demonstration and repeated practice, Shanghai takes the lead in incorporating a mature cancer screening measure into public health services, thereby making a breakthrough in the cancer screening for large-scale population in China in terms of public health policies. This paper reviews the whole process from both the design and the community pilot study of the above-mentioned program to the formulation of relevant public health policies as well as the promotion thereof across the whole city, and discusses how related technical and implementation issues can be resolved by utilizing evidence-based methods when the technical measure of CRC screening turns into public health service projects and is promoted and implemented among population.