Zarychanski Ryan, Chen Yue, Bernstein Charles N, Hébert Paul C
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ont.
CMAJ. 2007 Sep 11;177(6):593-7. doi: 10.1503/cmaj.070558.
Mortality associated with colorectal cancer can be reduced by early detection. However, the participation of eligible people in colorectal cancer screening is thought to be inadequate. We examined the frequency of colorectal cancer screening in 4 Canadian provinces and the influence of patient contact with a family physician on the uptake of cancer screening.
We performed analyses using data from the 2003 Canadian Community Health Survey. The study population included 12,776 people at average risk for colon cancer living in British Columbia, Saskatchewan, Ontario, and Newfoundland and Labrador who were aged 50 years or older and who were eligible for colorectal cancer screening. We assessed the proportion of respondents who reported having previous colorectal cancer screening tests and the degree of contact with a family physician.
The provincial response rates for the survey were 78.5%-87.0%. The proportion of respondents who reported any history of colorectal cancer screening was 23.5%. This value dropped to 17.6% when only up-to-date screening was considered (screening within the time frame recommended in guidelines). The proportion of people with up-to-date colorectal cancer screening varied significantly among provinces, but it was low in all provinces sampled. Contact with a family physician was associated with increased colorectal cancer screening. Compared with no physician contact, the odds of screening associated with 1-2 physician contacts in the 12 months before the survey was 1.97 (95% confidence interval [CI] 1.56-2.48], and the odds of screening associated with more than 4 contacts was 2.75 (95% CI 2.14-3.53).
Self-reported colorectal cancer screening falls well below acceptable levels. People with increased contact with a family physician are more likely than those without contact to report a history of up-to-date colorectal cancer screening.
早期发现可降低结直肠癌相关死亡率。然而，符合条件的人群参与结直肠癌筛查的情况被认为并不理想。我们研究了加拿大4个省份的结直肠癌筛查频率以及患者与家庭医生的接触对癌症筛查接受度的影响。
我们使用2003年加拿大社区健康调查的数据进行分析。研究人群包括居住在不列颠哥伦比亚省、萨斯喀彻温省、安大略省以及纽芬兰与拉布拉多省的12776名患结肠癌平均风险的50岁及以上人群，他们符合结直肠癌筛查条件。我们评估了报告曾进行过结直肠癌筛查测试的受访者比例以及与家庭医生的接触程度。
该调查在各省的回应率为78.5% - 87.0%。报告有任何结直肠癌筛查史的受访者比例为23.5%。若仅考虑最新筛查（在指南推荐的时间范围内进行筛查），这一比例降至17.6%。最新结直肠癌筛查人群的比例在各省之间差异显著，但在所有抽样省份中均较低。与家庭医生的接触与结直肠癌筛查增加相关。与未接触医生相比，在调查前12个月内与医生有1 - 2次接触的人群进行筛查的几率为1.97（95%置信区间[CI] 1.56 - 2.48），与医生有4次以上接触的人群进行筛查的几率为2.75（95% CI 2.14 - 3.53）。
自我报告的结直肠癌筛查情况远低于可接受水平。与家庭医生接触增多的人群比未接触的人群更有可能报告有最新结直肠癌筛查史。
