退伍军人对结直肠癌筛查的知识、态度和信念：读写能力有影响吗？

Colorectal cancer screening knowledge, attitudes, and beliefs among veterans: does literacy make a difference?

作者信息

Dolan Nancy C, Ferreira M Rosario, Davis Terry C, Fitzgibbon Marian L, Rademaker Alfred, Liu Dachao, Schmitt Brian P, Gorby Nicolle, Wolf Michael, Bennett Charles L

机构信息

Midwest Center for Health Services and Policy Research, VA Chicago Healthcare System, Department of Medicine, Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA.

出版信息

J Clin Oncol. 2004 Jul 1;22(13):2617-22. doi: 10.1200/JCO.2004.10.149.

DOI:10.1200/JCO.2004.10.149

PMID:15226329

Abstract

PURPOSE

To evaluate whether lower literacy is associated with poorer knowledge and more negative attitudes and beliefs toward colorectal cancer screening among veterans without recent colorectal cancer screening.

PATIENTS AND METHODS

Three hundred seventy-seven male veterans, age 50 years and older, who had not undergone recent colorectal cancer screening, were surveyed about their knowledge, attitudes, and beliefs regarding colorectal cancer screening. Patients' literacy was assessed with the Rapid Estimate of Adult Literacy in Medicine, an individually administered screening test for reading.

RESULTS

Thirty-six percent of the 377 men had an eighth grade literacy level or higher. Men with lower literacy were 3.5 times as likely not to have heard about colorectal cancer (8.8% v 2.5%; P =.006), 1.5 times as likely not to know about screening tests (58.4% v 40.9%; P =.0001), and were more likely to have negative attitudes about fecal occult blood testing (FOBT), but not about flexible sigmoidoscopy. Specifically, men with lower literacy skills were two times as likely to be worried that FOBT was messy (26.7% v 13.3%; P =.008), 1.5 times as likely to feel that FOBT was inconvenient (28.7% v 18%; P =.05), and four times as likely to state they would not use an FOBT kit even if their physician recommended it (17.9% v 4.0%; P =.02).

CONCLUSION

Limited literacy may be an overlooked barrier in colorectal cancer screening among veterans.

摘要

目的

评估在近期未进行过结直肠癌筛查的退伍军人中，较低的读写能力是否与对结直肠癌筛查的知识了解较少、态度和信念更消极有关。

患者与方法

对377名年龄在50岁及以上、近期未进行过结直肠癌筛查的男性退伍军人进行了关于他们对结直肠癌筛查的知识、态度和信念的调查。采用医学成人读写能力快速评估法对患者的读写能力进行评估，这是一种针对阅读能力的个体筛查测试。

结果

377名男性中，36%的人读写能力达到八年级及以上水平。读写能力较低的男性未听说过结直肠癌的可能性是其他人的3.5倍（8.8%对2.5%；P = 0.006），不知道筛查测试的可能性是其他人的1.5倍（58.4%对40.9%；P = 0.0001），并且对粪便潜血试验（FOBT）持更消极的态度，但对乙状结肠镜检查则不然。具体而言，读写能力较低的男性担心FOBT操作麻烦的可能性是其他人的两倍（26.7%对13.3%；P = 0.008），觉得FOBT不方便的可能性是其他人的1.5倍（28.7%对18%；P = 0.05），表示即使医生推荐也不会使用FOBT检测试剂盒的可能性是其他人的四倍（17.9%对4.0%；P = 0.02）。