Zhao Guixiang, Ford Earl S, Ahluwalia Indu B, Li Chaoyang, Mokdad Ali H
Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
J Gen Intern Med. 2009 Feb;24(2):270-5. doi: 10.1007/s11606-008-0858-8. Epub 2008 Dec 17.
Diabetes increases the risk of breast and colorectal cancers and has an undetermined relationship to cervical cancer. Improved screenings for these cancers are effective in reducing cancer mortality.
To examine the prevalence of receiving recommended screenings for these cancers and to assess the trends in the screening rates over time among US women with diagnosed diabetes in comparison with women without diabetes.
Cross-sectional.
A total of 63,650 to 182,168 adult women participated in the 1996-2006 (biennially) Behavioral Risk Factor Surveillance System.
The prevalence of receiving cancer screenings was age-standardized to the 2000 US population. The adjusted prevalence and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated using logistic regression analyses. The linear trends in the screening rates were tested using orthogonal polynomial contrasts.
In 2006, women with diabetes had a lower adjusted prevalence (74% versus 79%, P < 0.05) and the AOR (0.73, 95% CI: 0.66-0.81) for receiving cervical cancer screenings, but had a higher adjusted prevalence (63% versus 60%, P < 0.05) and the AOR (1.14, 95% CI: 1.04-1.24) for receiving colorectal cancer screenings compared to those without. In both women with diabetes and those without, the screening rate for colorectal cancer increased linearly during 2002-2006, whereas the screening rates for breast and cervical cancers changed little during 1996-2006.
Women with diabetes were equally likely to be screened for breast cancer, less likely to be screened for cervical cancer, but more likely to be screened for colorectal cancer compared to those without. Overall, the screening rates in both groups remain below the recommended levels.
糖尿病会增加患乳腺癌和结直肠癌的风险,与宫颈癌的关系尚不明确。改进这些癌症的筛查对于降低癌症死亡率是有效的。
研究美国糖尿病确诊女性接受这些癌症推荐筛查的患病率,并评估与非糖尿病女性相比,随时间推移筛查率的变化趋势。
横断面研究。
共有63650至182168名成年女性参加了1996 - 2006年(每两年一次)的行为危险因素监测系统。
癌症筛查的患病率按照2000年美国人口进行年龄标准化。使用逻辑回归分析估计调整后的患病率和调整后的比值比(AOR)以及95%置信区间(CI)。使用正交多项式对比检验筛查率的线性趋势。
2006年,糖尿病女性接受宫颈癌筛查的调整后患病率较低(分别为74%和79%,P < 0.05),AOR为0.73(95%CI:0.66 - 0.81),但接受结直肠癌筛查的调整后患病率较高(分别为63%和60%,P < 0.05),AOR为1.14(95%CI:1.04 - 1.24)。在糖尿病女性和非糖尿病女性中,2002 - 2006年期间结直肠癌的筛查率呈线性增加,而1996 - 2006年期间乳腺癌和宫颈癌的筛查率变化不大。
与非糖尿病女性相比,糖尿病女性接受乳腺癌筛查的可能性相同,接受宫颈癌筛查的可能性较小,但接受结直肠癌筛查的可能性较大。总体而言,两组的筛查率均低于推荐水平。