Dolan Nancy C, Ferreira M Rosario, Fitzgibbon Marian L, Davis Terry C, Rademaker Alfred W, Liu Dachao, Lee June, Wolf Michael, Schmitt Brian P, Bennett Charles L
Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Am J Prev Med. 2005 Jun;28(5):479-82. doi: 10.1016/j.amepre.2005.02.002.
Population-based studies from Medicare and privately insured individuals have consistently identified lower rates of colorectal cancer-screening tests among African-American versus white individuals. The purpose of this study was to evaluate whether, at a Veterans Affairs (VA) medical center, similar racial/ethnic differences in colorectal cancer screening could be identified.
Study participants were male veterans, aged > or =50, attending a general medicine clinic in a VA hospital, who had not had either a fecal occult blood test (FOBT) within the past year or a flexible sigmoidoscopy/colonoscopy within the past 5 years. Based on review of electronic medical records, rates of physician recommendation for FOBT, flexible sigmoidoscopy, or colonoscopy, and patient completion of these tests were obtained and compared by race/ethnicity.
Sixty percent of 1599 veterans had not undergone recent colorectal cancer screening. Physicians recommended colorectal screening tests equally among African-American and white patients (71.0% vs 68.2%, p=0.44). African-American patients were 1.3 times more likely than white patients to receive colorectal screening procedures (36.3% vs 28.9%, p=0.03).
In contrast to other settings, in a general medicine clinic at a VA hospital, rates of colorectal cancer-screening tests were not lower for African-American patients compared to white patients.
基于医疗保险和私人保险人群的研究一致表明,非裔美国人与白人相比,结直肠癌筛查测试的比率较低。本研究的目的是评估在退伍军人事务(VA)医疗中心是否能发现类似的结直肠癌筛查种族/民族差异。
研究参与者为年龄≥50岁的男性退伍军人,他们在VA医院的普通内科门诊就诊,且在过去一年中未进行粪便潜血试验(FOBT),或在过去5年中未进行乙状结肠镜/结肠镜检查。通过查阅电子病历,获取医生对FOBT、乙状结肠镜或结肠镜检查的推荐率,以及患者完成这些检查的情况,并按种族/民族进行比较。
1599名退伍军人中有60%最近未接受结直肠癌筛查。医生对非裔美国患者和白人患者进行结直肠癌筛查的推荐率相同(71.0%对68.2%,p = 0.44)。非裔美国患者接受结直肠癌筛查程序的可能性比白人患者高1. .3倍(36.3%对28.9%,p = 0.03)。
与其他情况不同,在VA医院的普通内科门诊,非裔美国患者的结直肠癌筛查测试比率与白人患者相比并不低。