Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA.
J Gen Intern Med. 2011 Oct;26(10):1124-30. doi: 10.1007/s11606-011-1727-4. Epub 2011 May 4.
Colorectal cancer (CRC) is the second most commonly diagnosed cancer among Hispanics in the United States (US), yet the use of CRC screening is low in this population. Physician recommendation has consistently shown to improve CRC screening.
To identify the characteristics of Hispanic patients who adhere or do not adhere to their physician's recommendation to have a screening colonoscopy.
A cross-sectional study featuring face-to-face interviews by culturally matched interviewers was conducted in primary healthcare clinics and community centers in New York City.
Four hundred Hispanic men and women aged 50 or older, at average risk for CRC, were interviewed. Two hundred and eighty (70%) reported receipt of a physician's recommendation for screening colonoscopy and are included in this study.
Dependent variable: self report of having had screening colonoscopy.
sociodemographics, healthcare and health promotion factors.
Of the 280 participants, 25% did not adhere to their physician's recommendation. Factors found to be associated with non-adherence were younger age, being born in the US, preference for completing interviews in English, higher acculturation, and greater reported fear of colonoscopy testing. The source of colonoscopy recommendation (whether it came from their usual healthcare provider or not, and whether it occurred in a community or academic healthcare facility) for CRC screening was not associated with adherence.
This study indicates that potentially identifiable subgroups of Hispanics may be less likely to follow their physician recommendation to have a screening colonoscopy and thus may decrease their likelihood of an early diagnosis and prompt treatment. Raising physicians' awareness to such patients' characteristics could help them anticipate patients who may be less adherent and who may need additional encouragement to undergo screening colonoscopy.
在美国，结直肠癌（CRC）是西班牙裔人群中第二大常见的癌症，但这一人群的 CRC 筛查率较低。医生的建议一直被证明可以提高 CRC 筛查率。
确定接受或不接受医生建议进行筛查结肠镜检查的西班牙裔患者的特征。
这是一项横断面研究，在纽约市的初级保健诊所和社区中心，由文化匹配的访谈员进行面对面访谈。
共访谈了 400 名年龄在 50 岁或以上、平均 CRC 风险的西班牙裔男女。其中 280 名（70%）报告收到了医生建议进行筛查结肠镜检查，他们被纳入本研究。
因变量：自我报告进行了筛查结肠镜检查。
社会人口统计学、医疗保健和健康促进因素。
在 280 名参与者中，25%的人未遵循医生的建议。与不遵医嘱相关的因素有：年龄较小、出生于美国、更愿意用英语完成访谈、更高的文化融合度和更高的结肠镜检查恐惧报告。CRC 筛查的结肠镜检查建议来源（是否来自于他们的常规医疗服务提供者，以及是否发生在社区或学术医疗机构）与依从性无关。
本研究表明，某些特定的西班牙裔亚群可能不太可能遵循医生的建议进行筛查结肠镜检查，从而可能降低他们早期诊断和及时治疗的可能性。提高医生对这些患者特征的认识，可能有助于他们预测那些不太可能遵医嘱的患者，这些患者可能需要更多的鼓励来进行筛查结肠镜检查。
