Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, USA.
Am J Prev Med. 2010 Apr;38(4):389-95. doi: 10.1016/j.amepre.2009.12.027.
Native Americans from the Northern Plains have the highest age-adjusted cancer mortality compared to Native Americans from any other region in the U.S.
This study examined the utilization and determinants of cancer screening in a large sample of Native Americans from the Northern Plains.
A survey was administered orally to 975 individuals in 2004-2006 from three reservations and among the urban Native-American community in the service region of the Rapid City Regional Hospital. Data analysis was conducted in 2007-2008.
Forty-four percent of individuals reported ever receiving any cancer screening. Particularly low levels were found for breast, cervical, prostate, and colon cancer screening. In multivariate analyses, the strongest determinant of receiving cancer screening overall or cancer screening for a specific cancer site was recommendation for screening by a doctor or nurse. Other determinants associated with increased likelihood of ever having cancer screening included older age, female gender, and receiving physical exams more than once a year. Increased age was a determinant of breast cancer screening, and receiving physical exams was associated with cervical cancer screening.
Cancer screening was markedly underutilized in this sample of Native Americans from the Northern Plains. Future research should evaluate the potential for improving cancer screening.
与美国其他地区的原住民相比，来自北美大平原地区的原住民的癌症死亡率经年龄调整后最高。
本研究调查了来自北美大平原的大量原住民中癌症筛查的利用情况和决定因素。
2004-2006 年，我们在三个保留地和拉皮德城地区医院服务区域的城市原住民社区中，对 975 人进行了口头调查。2007-2008 年进行数据分析。
44%的人报告曾接受过任何癌症筛查。乳腺癌、宫颈癌、前列腺癌和结肠癌筛查的比例尤其低。在多变量分析中，接受癌症筛查或特定癌症部位筛查的最强决定因素是医生或护士的筛查建议。与增加接受癌症筛查的可能性相关的其他决定因素包括年龄较大、女性性别以及每年接受一次以上体检。年龄增长是乳腺癌筛查的决定因素，而体检则与宫颈癌筛查有关。
在这个来自北美大平原的原住民样本中，癌症筛查的利用率明显较低。未来的研究应该评估改善癌症筛查的潜力。
