Friedman Lois C, Puryear Lucy J, Moore Allison, Green Charles E
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas 77030, USA.
Psychooncology. 2005 Sep;14(9):786-91. doi: 10.1002/pon.906.
This study investigated breast and colorectal cancer screening among 196 low-income women being treated for psychiatric illnesses. Main outcome measures included breast self-examination (BSE), clinical breast examination (CBE), mammography, digital rectal examination (DRE), and fecal occult blood test (FOBT). Results indicated that 49% and 66% of women 40 years of age or older had obtained mammograms and CBEs, respectively, in the preceding year. Forty-four per cent of women 20 years of age or older reported monthly BSE. Forty-six per cent and 35% of women 50 years of age or older reported having digital rectal exams (DRE) or fecal occult blood tests (FOBT), respectively, in the preceding year. Multivariate analyses showed that physician recommendation of screening was the strongest predictor of having obtained a mammogram, CBE, DRE or FOBT in the preceding year. Physician recommendation and self-confidence in performing BSE were the strongest predictors of monthly BSE. These results highlight the importance of physician recommendation of adherence to screening guidelines for breast and colorectal cancer. Because psychiatrists frequently treat psychiatric patients on a regular basis, they are in a unique position to encourage cancer screening and to monitor compliance with their recommendations.
本研究调查了196名正在接受精神疾病治疗的低收入女性的乳腺癌和结直肠癌筛查情况。主要结局指标包括乳房自我检查(BSE)、临床乳房检查(CBE)、乳房X光检查、直肠指检(DRE)和粪便潜血试验(FOBT)。结果显示,40岁及以上女性中,分别有49%和66%的人在前一年进行了乳房X光检查和CBE。20岁及以上女性中有44%报告每月进行BSE。50岁及以上女性中,分别有46%和35%的人在前一年报告进行了直肠指检(DRE)或粪便潜血试验(FOBT)。多变量分析表明,医生对筛查的推荐是前一年进行乳房X光检查、CBE、DRE或FOBT的最强预测因素。医生的推荐和进行BSE的自信心是每月进行BSE的最强预测因素。这些结果凸显了医生推荐遵守乳腺癌和结直肠癌筛查指南的重要性。由于精神科医生经常定期治疗精神疾病患者,他们处于鼓励癌症筛查并监测患者对其建议依从性的独特地位。