Pollack Lori A, Blackman Donald K, Wilson Katherine M, Seeff Laura C, Nadel Marion R
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mail Stop K-55, Atlanta, GA 30341, USA.
Prev Chronic Dis. 2006 Apr;3(2):A50. Epub 2006 Mar 15.
Although colorectal cancer mortality rates in the general U.S. population declined slightly from 1992 to 2000, the rates for Hispanic men and women did not. Disparity in colorectal cancer screening among Hispanics may be an important factor in the unchanged mortality trends. This study examined rates of colorectal cancer test use among Hispanic and non-Hispanic adults in the United States.
Using sampling weights and logistic regression, we analyzed colorectal cancer test use among 5680 Hispanic and 104,733 non-Hispanic adults aged 50 years and older who participated in the 2002 Behavioral Risk Factor Surveillance System. We estimated the percentages and adjusted odds ratios (ORs) of the respondents' reported test use by sociodemographic characteristics, health care access, and state or territory of residence.
Hispanic respondents aged 50 and older reported having had either a fecal occult blood test within the past year or a lower endoscopy (sigmoidoscopy or colonoscopy) within 10 years less frequently (41.9%) than non-Hispanic respondents (55.2%). Rates of test use were lower for respondents who reported less education, lower income, no health insurance, and no usual source of health care, regardless of Hispanic ethnicity. After adjusting for differences in education, income, insurance, and having a usual source of health care, Hispanic respondents remained less likely than non-Hispanic respondents to report colorectal cancer testing (OR for fecal occult blood test, 0.66; 95% confidence interval [CI], 0.56-0.81; OR for lower endoscopy, 0.87; 95% CI, 0.77-0.99). Greater disparity in screening rates between Hispanics and non-Hispanics was observed in Colorado, California, and Texas than in other states.
A disparity exists between Hispanic and non-Hispanic U.S. adults in colorectal cancer test use. This disparity varies among the states, highlighting the diverse health care experience of Hispanic adults in the United States.
尽管1992年至2000年间美国普通人群的结直肠癌死亡率略有下降，但西班牙裔男性和女性的死亡率并未下降。西班牙裔人群在结直肠癌筛查方面的差异可能是死亡率趋势未变的一个重要因素。本研究调查了美国西班牙裔和非西班牙裔成年人的结直肠癌检测使用率。
我们使用抽样权重和逻辑回归分析了5680名西班牙裔和104733名50岁及以上非西班牙裔成年人的结直肠癌检测使用情况，这些成年人参与了2002年行为危险因素监测系统。我们根据社会人口学特征、医疗保健可及性以及居住州或地区，估计了受访者报告的检测使用率的百分比和调整后的优势比（OR）。
50岁及以上的西班牙裔受访者报告在过去一年中进行过粪便潜血检测或在10年内进行过低位内镜检查（乙状结肠镜检查或结肠镜检查）的频率（41.9%）低于非西班牙裔受访者（55.2%）。无论西班牙裔种族如何，报告教育程度较低、收入较低、没有医疗保险且没有固定医疗保健来源的受访者的检测使用率较低。在调整了教育、收入、保险和有固定医疗保健来源的差异后，西班牙裔受访者报告进行结直肠癌检测的可能性仍低于非西班牙裔受访者（粪便潜血检测的OR为0.66；95%置信区间[CI]，0.56 - 0.81；低位内镜检查的OR为0.87；95% CI，0.77 - 0.99）。在科罗拉多州、加利福尼亚州和得克萨斯州，西班牙裔和非西班牙裔之间筛查率的差异比其他州更大。
美国西班牙裔和非西班牙裔成年人在结直肠癌检测使用方面存在差异。这种差异在各州有所不同，凸显了美国西班牙裔成年人多样化的医疗保健经历。
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