[20110826. screening endoscopy (4): opportunistic screening]
'±¹°¡¾Ï°ü¸®»ç¾÷ À̷аú ½ÇÁ¦' 80ÂÊ¿¡¼ ¿Å±é´Ï´Ù. "¾Ï°ËÁøÀº Å©°Ô Áý´Ü°ËÁø (organised screening, mass screening, population screening)°ú °³ÀΰËÁø (individualized screening, opportunistic screening)À¸·Î ±¸ºÐÇÒ ¼ö ÀÖ´Ù." ÀÌ Áß¿¡¼ opportunistic screeningÀ̶ó´Â ¿ë¾î°¡ Á¦ °ü½ÉÀ» ²ü´Ï´Ù.
Colorectal cancer screening: opportunistic or organized? (Rabeneck . Can J Gastroenterol 2006;20:249-250)¸¦ ¼Ò°³ÇÕ´Ï´Ù. ±× ÀϺθ¦ ¿Å±é´Ï´Ù.
Áú¹® (Paul Adams, Editor-in-chief): Can you explain the current practice of opportunistic screening and how it compares with the program that you are proposing?
´äº¯ (Linda Rabeneck): Opportunistic screening is what we are all doing now in Canada. This is completely ad hoc. It depends on either a general practitioner or the patient raising the issue, and because this often is not mentioned during an office visit, screening does not happen. For example, we know that less than 20% of screen-eligible individuals in Ontario are screened, using any method. Organized screening would include, at a minimum, the following:
- invitations to screen targeted at the screen-eligible population;
- information technology infrastructure to support the screening program;
- timely access to screening and follow-up tests (colonoscopy);
- quality assurance (credentialing of endoscopist, measurement of colonoscopy adverse events, measurement of proportion of incomplete colonoscopies, etc); and
- tracking of clinical outcomes (CRC incidence, CRC stage, CRC mortality).
2008³â ¿ì¸®³ª¶ó À§¾Ï °ËÁø±Ç°í¾È ÀÌÇà ¼ö°Ë·üÀº 53.5%¿´½À´Ï´Ù. ÀÌ Áß¿¡¼ ¾î´À Á¤µµ°¡ opportunistic screeningÀÎÁö ¸íÈ®È÷ ¹àÈù ÀڷḦ º» ÀûÀÌ ¾ø½À´Ï´Ù. ´Ù¸¸ '±¹°¡¾Ï°ü¸®»ç¾÷ À̷аú ½ÇÁ¦'¿¡¼ ¾à°£ÀÇ ÈùÆ®¸¦ ¾òÀ» ¼ö ÀÖÀ» »ÓÀÔ´Ï´Ù. 87-88ÂÊ¿¡¼ ¿Å±é´Ï´Ù.
"2007³â ±¹°¡¾ÏÁ¶±â°ËÁø»ç¾÷ÀÇ °æ¿ì Àüü ´ë»óÀÚÀÇ ¾à 24%, °ø´Ü ƯÁ¤¾Ï°Ë»çÀÇ °æ¿ì ¾à 31%°¡ ¾Ï°ËÁø»ç¾÷¿¡ Âü¿©ÇÏ¿´´Ù. ÇÑÆí ¿ì¸®³ª¶ó ±¹¹ÎÀÇ 50.7%´Â 5´ë¾Ï °ËÁø±Ç°í¾Ï¿¡ µû¶ó °ËÁøÀ» ¹Þ°í ÀÖ´Â °ÍÀ¸·Î Á¶»çµÇ¾ú´Ù. ÀÌ´Â °ø°ø°ËÁø°ú °³ÀΰËÁøÀ» ¸ðµÎ Æ÷ÇÔÇÑ °ÍÀ¸·Î 2004³â 38.8%¿¡ ºñÇØ 11.9% Æ÷ÀÎÆ®°¡ Áõ°¡ÇÑ ¼öÄ¡ÀÌ´Ù."
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