Friedemann-Sánchez Greta, Griffin Joan M, Partin Melissa R
Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN 55417, USA.
Health Expect. 2007 Jun;10(2):148-60. doi: 10.1111/j.1369-7625.2006.00430.x.
CONTEXT: Several prior studies have found that women are less likely to be screened for colorectal cancer (CRC) than men. While the source of this screening differential is unknown, recent studies suggest gender differences in barriers to screening might explain the disparity. OBJECTIVE: This formative study was designed to explore CRC screening barriers, attitudes and preferences by gender. METHODOLOGY: Focus group interviews with groups stratified by gender and screening status. Participants included 27 females and 43 males between the ages of 50 and 75 years who receive primary care at the Minneapolis VA Medical Center. We conducted interpretive and grounded text analysis of semi-structured focus group interviews to assess how knowledge, experiences and sociocultural norms shape female and male preferences and barriers to current CRC screening guidelines. RESULTS: Female and male participants reported similar preferences for CRC screening mode, but there were notable differences in the barriers and facilitators to screening. Key findings suggest that women viewed the preparation for endoscopic procedures as a major barrier to screening while men did not; women and men expressed different fears and information preferences regarding endoscopic procedures; and women perceive CRC as a male disease thus feeling less vulnerable to CRC. Gender-specific barriers may explain women's lower rate of screening for CRC. CONCLUSION: Colorectal cancer screening promotion interventions, decision aids and clinical practice may benefit by being tailored by gender.
背景:此前的多项研究发现,与男性相比,女性接受结直肠癌(CRC)筛查的可能性较小。虽然这种筛查差异的根源尚不清楚,但最近的研究表明,筛查障碍方面的性别差异可能解释了这种差距。 目的:这项形成性研究旨在按性别探索CRC筛查障碍、态度和偏好。 方法:对按性别和筛查状态分层的群体进行焦点小组访谈。参与者包括27名女性和43名男性,年龄在50至75岁之间,他们在明尼阿波利斯退伍军人事务医疗中心接受初级保健。我们对半结构化焦点小组访谈进行了解释性和基于实证的文本分析,以评估知识、经验和社会文化规范如何塑造女性和男性对当前CRC筛查指南的偏好和障碍。 结果:女性和男性参与者对CRC筛查方式的偏好相似,但在筛查的障碍和促进因素方面存在显著差异。主要发现表明,女性将内镜检查的准备工作视为筛查的主要障碍,而男性则不然;女性和男性在内镜检查方面表达了不同的恐惧和信息偏好;女性认为CRC是男性疾病,因此感觉自己患CRC的可能性较小。特定性别的障碍可能解释了女性较低的CRC筛查率。 结论:结直肠癌筛查促进干预措施、决策辅助工具和临床实践可能因按性别进行调整而受益。
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