Christie Jennifer, Hooper Charlene, Redd William H, Winkel Gary, DuHamel Katherine, Itzkowitz Steven, Jandorf Lina
Division of Gastroenterology, Mount Sinai School of Medicine New York, NY 10029, USA.
J Natl Med Assoc. 2005 Oct;97(10):1361-8.
Colorectal cancer (CRC) is the second leading cause of cancer related deaths in the United States. Underrepresented minorities suffer disproportionately from CRC largely because of disparities in CRC screening rates, particularly by endoscopic methods. This study evaluates the association between socioeconomic, medical and psychosocial factors and the use of endoscopy in low-income minority women.
The participants were recruited from community health fairs, tenant association meetings, senior centers and local medical clinics. A survey instrument was administered to the minority women.
Eighty-one women age >50 were included in this analysis (44 African Americans and 37 Hispanics). The two ethnic groups were demographically similar. The factors associated with having had endoscopy were language spoken (English versus Spanish), physician recommendation, cancer cons and decisional balance (difference between cancer cons and cancer pros). When endoscopy was modeled as a function of decisional balance and language spoken, only decisional balance was a significant predictor of endoscopy.
Physician recommendation and decisional balance have a tremendous influence on whether minority women undergo endoscopy. These data suggest that if physicians increase their communication with patients regarding the benefits of screening and address patients concerns, adherence with endoscopic CRC screening can be improved in minority women.
在美国，结直肠癌（CRC）是癌症相关死亡的第二大主要原因。少数族裔在结直肠癌方面所受影响尤为严重，这主要是由于结直肠癌筛查率存在差异，尤其是在内镜检查方法方面。本研究评估了社会经济、医学和心理社会因素与低收入少数族裔女性内镜检查使用之间的关联。
参与者从社区健康博览会、租户协会会议、老年中心和当地医疗诊所招募。对少数族裔女性进行了一项调查。
本分析纳入了81名年龄大于50岁的女性（44名非裔美国人和37名西班牙裔）。这两个种族在人口统计学上相似。与进行过内镜检查相关的因素包括所讲语言（英语与西班牙语）、医生建议、癌症负面因素和决策平衡（癌症负面因素与癌症正面因素之间的差异）。当将内镜检查作为决策平衡和所讲语言的函数进行建模时，只有决策平衡是内镜检查的显著预测因素。
医生建议和决策平衡对少数族裔女性是否接受内镜检查有巨大影响。这些数据表明，如果医生加强与患者关于筛查益处的沟通并解决患者的担忧，少数族裔女性对结直肠癌内镜筛查的依从性可以得到提高。
