Participation au dépistage du cancer colorectal selon le taux de pauvreté dans les Bouches-du-Rhône.

INTRODUCTION: The rate of participation in organized colorectal cancer screening (DOCCR) remains insufficient in France, with strong disparities between departments. PURPOSE OF RESEARCH: The aim of this work was to assess the relationship between the DOCCR response rates for the communes of the Bouches-du-Rhône (BdR) department and the boroughs of Marseille and their poverty levels. The DOCCR response rate was assessed for the 2017-2018 campaign. The Pearson coefficient was calculated to assess correlations with the average poverty rate per commune/borough, the density of general practitioners (GPs) and Potential Localized Accessibility (PLA) to GPs. RESULTS: Among the DOCCR guests, 29.7% (± 4.7) responded. The rate of respondents differed significantly between the communes/boroughs of the department (P < 0.001). The rate of respondents was inversely correlated with the rate of people living below the poverty line, both for the communes/boroughs of the department, with a high correlation (r = - 0.795, P < 0.001) and for the Marseille boroughs, with an even higher correlation (r = - 0.910, P < 0.001). It was inversely correlated with the density of GPs (r = - 0.430, P < 0.001). On the other hand, there was a weak positive correlation with Potential Localized Accessibility to GPs (r = 0.193, P < 0.001), as well as with the age of guests (r = 0.476, P < 0.001). CONCLUSIONS: The poverty rate in the BdR, which is higher than the national average, may partly explain the low rate of DOCCR respondents; other factors such as the density of GPs and their accessibility may play a role.

Disclosure of research results: a randomized study on GENEPSO-PS cohort participants.

BACKGROUND: There exist no recommendations as to how aggregate research results should best be disclosed to long-term cohort participants. OBJECTIVE: To study the impact of cohort results disclosure documents of various kinds on participants' satisfaction. DESIGN: Randomized study with a 2x2 factorial design. SETTING AND PARTICIPANTS: The GENEPSO-PS cohort is used to study the psychosocial characteristics and preventive behaviour of both BRCA1/2 carriers and non-carriers; 235 participants wishing to receive 'information about the survey results' answered a self-administered questionnaire. INTERVENTIONS: The impact of providing the following items in addition to a leaflet about aggregate psychosocial research results was investigated (i) an up-to-date medical information sheet about BRCA1/2 genetic topics, (ii) a photograph with the names of the researchers. MAIN OUTCOME MEASURES: Satisfaction profiles drawn up using cluster analysis methods. RESULTS: Providing additional medical and/or research team information had no significant effect on satisfaction. The patients attributed to the 'poorly satisfied' group (n = 60, 25.5%) differed significantly from those in the 'highly satisfied' group (n = 51, 21.7%): they were younger [odds ratio (OR) = 0.96, 95% confidence interval (0.92-0.99), P = 0.028], less often had a daughter [OR = 4.87 (1.80-13.20), P = 0.002], had reached a higher educational level [OR = 2.94 (1.24-6.95), P = 0.014] and more frequently carried a BRCA1/2 mutation [OR = 2.73 (1.20-6.23), P = 0.017]. CONCLUSIONS: This original approach to disclosing research results to cohort participants was welcomed by most of the participants, but less by the more educated and by BRCA1/2 carriers. Although an easily understandable document is necessary, it might also be worth providing some participants with more in-depth information.

Network meta-analysis to evaluate the effectiveness of interventions to increase the uptake of smoke alarms.

This study is the first known to use network meta-analysis to simultaneously evaluate the effectiveness of interventions to increase the prevalence of functioning smoke alarms in households with children. The authors identified 24 primary studies from a systematic review of reviews and of more recently published primary studies, of which 23 (17 randomized controlled trials and 6 nonrandomized comparative studies) were included in 1 of the following 2 network meta-analyses: 1) possession of a functioning alarm: interventions that were more "intensive" (i.e., included components providing equipment (with or without fitting), home inspection, or both, in addition to education) generally were more effective. The intervention containing all of the aforementioned components was identified as being the most likely to be the most effective (probability (best) = 0.66), with an odds ratio versus usual care of 7.15 (95% credible interval: 2.40, 22.73); 2) type of battery-powered alarms: ionization alarms with lithium batteries were most likely to be the best type for increasing functioning possession (probability (best) = 0.69). Smoke alarm promotion programs should ensure they provide the combination of interventions most likely to be effective.