McQueen Amy, Vernon Sally W, Meissner Helen I, Klabunde Carrie N, Rakowski William
Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, 77030, USA.
Cancer Epidemiol Biomarkers Prev. 2006 Apr;15(4):782-91. doi: 10.1158/1055-9965.EPI-05-0629.
Despite evidence that screening tests reduce colorectal cancer incidence and mortality, screening prevalence is low. Gender differences in test uptake have been reported, but few studies examine correlates of test use by gender. Differences, if present, may inform strategies to increase test use. We examined gender differences in the prevalence and correlates of colorectal cancer test use [fecal occult blood test (FOBT) and endoscopy] using data from the 2002 to 2003 Health Information National Trends Survey. Male (n = 999) and female (n = 1687) respondents ages > or =50 years, without a personal history of colorectal cancer, were interviewed by telephone. Age-adjusted prevalence rates were reported for lifetime, recent, and repeat use by gender and test type. Multivariable logistic regression analyses were used to identify correlates of test use stratified by gender and colorectal cancer test type. More females reported only using FOBT in lifetime and in the past year, whereas more males reported repeat endoscopy use. The use of other tests or combinations of tests did not differ by gender. Consistent positive correlates of colorectal cancer test use for both genders included age, recent physician visits, recent breast or prostate cancer screening, and knowledge of test-specific screening intervals. Correlates that differed by gender included comparative perceived risk, belief that colorectal cancer testing was too expensive, fear of finding colorectal cancer if tested, and attention to and trust in media sources of health information. Such differences, if confirmed in future studies, may inform the use of gender-specific intervention strategies or messages to increase colorectal cancer test use.
尽管有证据表明筛查测试可降低结直肠癌的发病率和死亡率，但筛查普及率仍然很低。已有报告指出在检测接受率方面存在性别差异，但很少有研究考察按性别划分的检测使用相关因素。如果存在差异，可能会为增加检测使用的策略提供依据。我们利用2002年至2003年全国健康信息趋势调查的数据，研究了结直肠癌检测使用情况（粪便潜血试验[FOBT]和内窥镜检查）的普及率及相关因素中的性别差异。年龄大于或等于50岁、无结直肠癌个人病史的男性（n = 999）和女性（n = 1687）受访者接受了电话访谈。报告了按性别和检测类型划分的终生、近期和重复使用的年龄调整普及率。多变量逻辑回归分析用于确定按性别和结直肠癌检测类型分层的检测使用相关因素。更多女性报告仅在终生和过去一年中使用FOBT，而更多男性报告重复使用内窥镜检查。其他检测或检测组合的使用在性别上没有差异。结直肠癌检测使用的一致正向相关因素对两性而言都包括年龄、近期看医生、近期乳腺癌或前列腺癌筛查以及对特定检测筛查间隔的了解。因性别而异的相关因素包括比较感知风险、认为结直肠癌检测过于昂贵、担心检测出结直肠癌以及对健康信息媒体来源的关注和信任。如果这些差异在未来研究中得到证实，可能会为使用针对性别的干预策略或信息以增加结直肠癌检测使用提供依据。
