Mayer Deborah K, Terrin Norma C, Menon Usha, Kreps Gary L, McCance Kathy, Parsons Susan K, Mooney Kathleen H
Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, 750 Washington Street #345, Boston, MA 02111, USA.
J Cancer Surviv. 2007 Mar;1(1):17-26. doi: 10.1007/s11764-007-0007-0.
Ten percent of all new cancers are diagnosed in cancer survivors and second cancers are the sixth leading cause of cancer deaths. Little is known, however, about survivors' screening practices for other cancers. The purpose of this study was to examine the impact of a cancer diagnosis on survivors' screening beliefs and practices compared to those without a cancer history.
This study examined cancer survivors' (n = 619) screening beliefs and practices compared to those without cancer (n = 2,141) using the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS).
The typical participant was Caucasian, employed, married, and female with at least a high school education, having a regular health care provider and health insurance. Being a cancer survivor was significantly associated with screening for colorectal cancer but not for breast or prostate cancer screening. Screening adherence exceeded American Cancer Society recommendations, national prevalence data, and Healthy People 2010 goals for individual tests for both groups. Physician recommendations were associated with a higher level of screening but recommendations varied (highest for breast cancer and lowest for colorectal cancer screening).
Cancer survivors had different health beliefs and risk perceptions for screening compared to the NoCancer group. While there were no differences between survivors' screening for breast and prostate cancer, survivors were more likely to screen for colorectal cancer than the comparison group. Screening adherence met or exceeded recommendations for individual tests for both cancer survivors and the comparison group.
Cancer survivors should continue to work with their health care providers to receive age and gender appropriate screening for many types of cancers. Screening for other cancers should also be included in cancer survivorship care plans.
所有新发癌症中有10%是在癌症幸存者中诊断出来的，二次癌症是癌症死亡的第六大主要原因。然而，对于幸存者针对其他癌症的筛查行为知之甚少。本研究的目的是检验癌症诊断对幸存者筛查信念和行为的影响，并与无癌症病史者进行比较。
本研究使用美国国立癌症研究所2003年的健康信息国家趋势调查（HINTS），对619名癌症幸存者与2141名无癌症者的筛查信念和行为进行了比较。
典型参与者为白人、就业、已婚、女性，至少具有高中学历，有固定的医疗服务提供者和医疗保险。作为癌症幸存者与结直肠癌筛查显著相关，但与乳腺癌或前列腺癌筛查无关。两组的筛查依从性均超过了美国癌症协会的建议、全国患病率数据以及《健康人民2010》中各项个体检查的目标。医生的建议与更高水平的筛查相关，但建议各不相同（乳腺癌最高，结直肠癌筛查最低）。
与无癌症组相比，癌症幸存者在筛查方面有不同的健康信念和风险认知。虽然幸存者在乳腺癌和前列腺癌筛查方面没有差异，但与对照组相比，幸存者更有可能进行结直肠癌筛查。癌症幸存者和对照组的筛查依从性均达到或超过了各项个体检查的建议。
癌症幸存者应继续与他们的医疗服务提供者合作，接受针对多种癌症的适合年龄和性别的筛查。对其他癌症的筛查也应纳入癌症生存护理计划。
