Emmons Karen, Puleo Elaine, McNeill Lorna H, Bennett Gary, Chan Sophia, Syngal Sapna
Dana-Farber Cancer Institute, Harvard School of Public Health, Center for Community-Based Research, Boston, MA 02115, USA.
Cancer Causes Control. 2008 Dec;19(10):1031-41. doi: 10.1007/s10552-008-9167-0. Epub 2008 May 14.
Colorectal cancer (CRC) screening rates in the US are suboptimal, particularly among lower income and racial/ethnically diverse groups. If specific populations have limited awareness of screening when they reach age 50, there may be delays in screening adoption. This study investigated sociodemographic and social contextual factors associated with awareness of CRC and intentions to be screened at age 50 among 692 low income, racial, and ethnic minority adults living in low income housing. The majority of respondents (62%) were between ages 30 and 49, and 94% had some form of health insurance (e.g., Medicaid). About 70% reported having heard about CRC screening; 66% reported intentions to be screened at age 50. In multivariable analyses, screening awareness was associated with age and education. Immigrants who had English as a second language had lower awareness. Females tended to have higher awareness if they had private insurance; there were no differences among males. Multivariable analyses found that screening intentions were higher among men, those with more role responsibilities, more role conflicts, and higher levels of social cohesion. It is important to identify opportunities for maximizing screening uptake among those who become age-eligible for screening if we are to make a significant impact on CRC disparities.
美国的结直肠癌(CRC)筛查率不理想,在低收入群体以及种族/民族多样化群体中尤其如此。如果特定人群在年满50岁时对筛查的认知有限,那么在接受筛查方面可能会出现延迟。本研究调查了692名居住在低收入住房中的低收入、种族和少数民族成年人中,与结直肠癌认知以及50岁时接受筛查意愿相关的社会人口统计学和社会背景因素。大多数受访者(62%)年龄在30至49岁之间,94%拥有某种形式的医疗保险(如医疗补助)。约70%的受访者表示听说过结直肠癌筛查;66%的受访者表示有在50岁时接受筛查的意愿。在多变量分析中,筛查认知与年龄和教育程度相关。以英语作为第二语言的移民认知较低。如果女性拥有私人保险,她们的认知往往较高;男性之间则没有差异。多变量分析发现,男性、承担更多角色责任、面临更多角色冲突以及社会凝聚力较高的人群接受筛查的意愿更高。如果我们要对结直肠癌差异产生重大影响,那么识别出那些达到筛查年龄资格人群中提高筛查接受率的机会非常重要。