Brounts Lionel R, Lehmann Ryan K, Lesperance Kelly E, Brown Tommy A, Steele Scott R
Department of Surgery, Madigan Army Medical Center, Fort, Lewis, WA, USA.
Am J Surg. 2009 May;197(5):609-12; discussion 612-3. doi: 10.1016/j.amjsurg.2008.12.006.
National colorectal cancer (CRC) screening averages 50% to 60%. We aimed to identify screening prevalence in select Department of Defense (DOD) beneficiaries with equal access to care.
December 2007 cross-sectional data of patients over 50 years of age included patient demographics, screening modality, and compliance.
Of 17,252 patients (52% male; mean age 63.2 +/- 8.1 years), 12,229 (71%) were up-to-date with national screening guidelines. Modalities included colonoscopy (83.0%), flexible sigmoidoscopy with fecal occult blood testing (FOBT) (32.2%), and air-contrast barium enema (0.7%). African American or Hispanic background (70% African American, 68% Hispanic vs 73% Caucasian), younger patients (66.1% <65 years vs 78.6% >65 years), and male gender (69.9% vs 72.1%; all P < .001) all had lower rates. Compared to 2005, more patients were current with guidelines (71% vs 64%) and colonoscopic screening (83% vs 71%).
Although ethnicity-, gender-, and age-related disparities were observed, screening rates are improved in an equal access healthcare system.
全国结直肠癌（CRC）筛查平均率为50%至60%。我们旨在确定在有同等医疗服务可及性的特定国防部（DOD）受益人群中的筛查患病率。
2007年12月对50岁以上患者的横断面数据包括患者人口统计学信息、筛查方式和依从性。
在17252名患者中（52%为男性；平均年龄63.2±8.1岁），12229名（71%）符合国家筛查指南。筛查方式包括结肠镜检查（83.0%）、乙状结肠镜检查联合粪便潜血试验（FOBT）（32.2%）和气钡双重造影灌肠（0.7%）。非裔美国人或西班牙裔背景（非裔美国人占70%；西班牙裔占68%，白种人占73%）、年轻患者（65岁以下占66.1%，65岁以上占78.6%）以及男性（69.9%对72.1%；所有P<0.001）的筛查率均较低。与2005年相比，更多患者符合指南要求（71%对64%）以及接受结肠镜筛查（83%对71%）。
尽管观察到种族、性别和年龄相关的差异，但在医疗服务可及性平等的医疗系统中筛查率有所提高。
