Trivers Katrina F, Shaw Kate M, Sabatino Susan A, Shapiro Jean A, Coates Ralph J
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia 30341, USA.
Am J Prev Med. 2008 Sep;35(3):185-93. doi: 10.1016/j.amepre.2008.05.021. Epub 2008 Jul 10.
Colorectal cancer (CRC) screening rates are low, and racial, ethnic, and economic disparities have been reported. Whether disparities in CRC screening have decreased over time is unknown. This study aimed to determine whether progress was made between 2000 and 2005 in reducing CRC screening disparities by race, ethnicity, income, and insurance status.
Age-adjusted percentages of participants aged 50-64 who reported CRC screening (home fecal occult blood test in the past year or endoscopy in the past 10 years) were estimated from the 2000 (n=6,020 participants) and 2005 (n=6,706) cancer control supplements of the National Health Interview Survey, with analysis in 2007.
Screening rates did not increase between 2000 and 2005 for Hispanic women or uninsured women. Only for high-income participants did screening exceed 50%. For both men and women, the uninsured had the lowest levels of screening (19.1% and 19.3%, respectively, in 2005), and the greatest disparities were observed among groups defined by health insurance status. For women, disparities by ethnicity, income, and insurance status increased over time, whereas among men, disparities in 2005 were similar to those in 2000. For Hispanic women, growing disparities were present at all income and insurance levels and persisted after additional adjustment.
No progress was made in reducing most CRC screening disparities between 2000 and 2005. Methods are needed to increase CRC screening among everyone, but in particular Hispanic women and uninsured men and women.
结直肠癌(CRC)筛查率较低,且存在种族、民族和经济差异的报道。目前尚不清楚CRC筛查方面的差异是否会随着时间推移而减少。本研究旨在确定在2000年至2005年期间,在按种族、民族、收入和保险状况减少CRC筛查差异方面是否取得了进展。
从2000年(n = 6020名参与者)和2005年(n = 6706名)美国国家健康访谈调查的癌症控制补充调查中估计报告进行CRC筛查(过去一年进行家庭粪便潜血试验或过去10年进行内镜检查)的50 - 64岁参与者的年龄调整百分比,并于2007年进行分析。
2000年至2005年期间,西班牙裔女性或未参保女性的筛查率没有增加。只有高收入参与者的筛查率超过了50%。对于男性和女性来说,未参保者的筛查水平最低(2005年分别为19.1%和19.3%),并且在按健康保险状况定义的群体中观察到最大的差异。对于女性,按种族、收入和保险状况划分的差异随时间增加,而对于男性,2005年的差异与2000年相似。对于西班牙裔女性,在所有收入和保险水平上差异都在扩大,并且在进一步调整后仍然存在。
2000年至2005年期间,在减少大多数CRC筛查差异方面没有取得进展。需要采取方法提高所有人的CRC筛查率,特别是西班牙裔女性以及未参保的男性和女性。