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未参保人群中的沟通与结直肠癌筛查:来自美国健康信息国家趋势调查的数据

Communication and colorectal cancer screening among the uninsured: data from the Health Information National Trends Survey (United States).

作者信息

Cairns Catherine P, Viswanath K

机构信息

Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA 02115, USA.

出版信息

Cancer Causes Control. 2006 Nov;17(9):1115-25. doi: 10.1007/s10552-006-0046-2.

Abstract

OBJECTIVE

Colorectal cancer screening allows for both prevention and early detection of the disease, with early detection often resulting in improved prognosis. Too few Americans over 50 are screened for colorectal cancer, but among certain subpopulations screening rates are particularly low for various reasons. We examined the role of communication factors and insurance, with a specific focus on the uninsured to examine disparities in colorectal cancer screening.

METHODS

We used Health Information National Trends Survey data to examine: disparities in colorectal cancer screening, by calculating proportions of subpopulations screened; and the association between communication and screening among the uninsured, by performing chi-square tests and simple logistic regression to examine the potential factors associated with screening.

RESULTS

The uninsured were 64% less likely to be screened than the insured. Provider recommendation was the only significant communication measure, with the uninsured lacking a recommendation 98.5% less likely to be screened than those with one.

CONCLUSION

These data suggest expansion of programs of screening among the uninsured and more aggressive communication campaigns to promote the awareness and provider recommendation of screening as possible ways to increase screening and reduce mortality of colorectal cancer.

摘要

目的

结直肠癌筛查有助于疾病的预防和早期发现,早期发现通常会改善预后。50岁以上接受结直肠癌筛查的美国人太少,但在某些亚人群中,由于各种原因筛查率特别低。我们研究了沟通因素和保险的作用,特别关注未参保人群,以探讨结直肠癌筛查中的差异。

方法

我们使用《健康信息国家趋势调查》数据来研究:通过计算各亚人群的筛查比例,分析结直肠癌筛查中的差异;通过卡方检验和简单逻辑回归分析未参保人群中沟通与筛查之间的关联,以检验与筛查相关的潜在因素。

结果

未参保人群接受筛查的可能性比参保人群低64%。医生建议是唯一显著的沟通措施,未得到医生建议的未参保人群接受筛查的可能性比得到医生建议的人群低98.5%。

结论

这些数据表明,扩大未参保人群的筛查项目,开展更积极的宣传活动,以提高对筛查的认识并促使医生给出建议,可能是增加筛查和降低结直肠癌死亡率的途径。

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