Hawley Sarah T, Vernon Sally W, Levin Bernard, Vallejo Beryl
Baylor College of Medicine, Department of Family and Community Medicine, Houston, Texas 77098, USA.
Cancer Epidemiol Biomarkers Prev. 2004 Feb;13(2):314-9. doi: 10.1158/1055-9965.epi-509-2.
The primary objective of this study was to determine the prevalence of colorectal cancer (CRC) screening among eligible patients in a large medical practice. A secondary objective was to compare CRC screening rates obtained from medical records with physician self-reported CRC screening recommendation. We conducted a retrospective record review of 214 patients ages > or = 50 years of a large multispecialty medical organization in Houston, Texas, for receipt of fecal occult blood test (FOBT), flexible sigmoidoscopy (SIG), and/or colonoscopy (COL). We estimated prevalence using two definitions: (a) FOBT in past year or SIG in past 5 years or COL in past 10 years; and (b) FOBT in past year and SIG in past 5 years or COL in past 10 years. Age, gender, race/ethnicity, family history, number of chronic conditions, and index visit were independent variables. Contingency table and logistic regression analysis were used to test for associations between outcomes and independent variables. Our study population was 48% male with a mean age of 63 years (range: 53-84 years). One-quarter of the records showed FOBT by 3-day kit (51 of 214) and 27% by digital rectal exam (57 of 214). SIG was recorded in 32% of records. Half (54%) of the records had documentation of CRC screening according to definition no. 1 and 19% according to definition no. 2. Screening rates from medical record review were lower than those derived from physician self-report. Our findings underscore the need for interventions to improve CRC screening in primary care settings.
本研究的主要目的是确定在一个大型医疗诊所中符合条件的患者进行结直肠癌（CRC）筛查的比例。次要目的是比较从病历中获得的CRC筛查率与医生自我报告的CRC筛查建议。我们对得克萨斯州休斯顿一个大型多专科医疗组织中214名年龄≥50岁的患者进行了回顾性病历审查，以了解其是否接受了粪便潜血试验（FOBT）、乙状结肠镜检查（SIG）和/或结肠镜检查（COL）。我们使用两种定义来估计比例：（a）过去一年进行FOBT或过去5年进行SIG或过去10年进行COL；（b）过去一年进行FOBT且过去5年进行SIG或过去10年进行COL。年龄、性别、种族/族裔、家族病史、慢性病数量和首次就诊是自变量。使用列联表和逻辑回归分析来检验结果与自变量之间的关联。我们的研究人群中48%为男性，平均年龄63岁（范围：53 - 84岁）。四分之一的记录显示通过3天试剂盒进行FOBT（214例中的51例），27%通过直肠指检（214例中的57例）。32%的记录中有SIG记录。根据定义1，一半（54%）的记录有CRC筛查记录，根据定义2为19%。病历审查得出的筛查率低于医生自我报告的筛查率。我们的研究结果强调了在初级保健环境中采取干预措施以改善CRC筛查的必要性。
