Department of Family and Community MedicineUniversity of New Mexico, Albuquerque, NM 87131-0001, USA.
Ethn Dis. 2011 Spring;21(2):202-9.
To determine the factors associated with cancer screening adherence among Native Americans living in California.
2,266 Native Americans identified from the California Health Interview Surveys during 2001, 2003, and 2005 eligible for cervical, breast, or colorectal cancer screening.
We fit multivariable logistic regression models to identify demographic and healthcare access predictors of adherence to cancer screening.
The presence of a recent physician visit was significantly associated with cervical (odds ratio [OR] 7.34, 95% confidence interval [CI] 4.27, 12.6), breast (OR 3.29, 95% CI 2.0, 5.42), and colorectal (OR 3.02, 95% Cl 1.74, 5.23) cancer screening adherence. The report of a usual source of care was similarly positively associated with cervical, breast, and colorectal cancer screening adherence. Additional predictors for colorectal cancer screening included higher educational attainment (OR 1.56, 95% Cl 1.07, 2.28), and the presence of a comorbid condition (OR 1.54, 95% CI 1.16, 2.05). Experiencing discrimination (OR .42, 95% Cl .20, .89) and never being married (OR .49, 95% CI .27, .89) were negative predictors of breast cancer screening, while having insurance (OR 2.00, 95% CI 1.27, 3.15) was a positive predictor. Cervical cancer screening was positively associated with living at or above 300% of the federal poverty level (OR 2.69, 95% CI 1.50, 4.85).
Regular access to health care and a physician are the most consistent predictors of cancer screening adherence among Native Americans and should represent a focus of activities to improve screening rates in these communities.
确定加利福尼亚州美洲原住民癌症筛查依从性的相关因素。
2001 年、2003 年和 2005 年从加利福尼亚健康访谈调查中确定的 2266 名符合宫颈癌、乳腺癌或结直肠癌筛查条件的美洲原住民。
我们拟合了多变量逻辑回归模型，以确定与癌症筛查依从性相关的人口统计学和医疗保健获取预测因素。
最近有医生就诊与宫颈癌（优势比 [OR] 7.34，95%置信区间 [CI] 4.27，12.6）、乳腺癌（OR 3.29，95%CI 2.0，5.42）和结直肠癌（OR 3.02，95%Cl 1.74，5.23）的筛查依从性显著相关。报告有常规医疗服务来源也与宫颈癌、乳腺癌和结直肠癌的筛查依从性呈正相关。结直肠癌筛查的其他预测因素包括较高的教育程度（OR 1.56，95%Cl 1.07，2.28）和合并症的存在（OR 1.54，95%CI 1.16，2.05）。经历歧视（OR.42，95%CI.20，.89）和从未结婚（OR.49，95%CI.27，.89）是乳腺癌筛查的负预测因素，而有保险（OR 2.00，95%CI 1.27，3.15）是正预测因素。宫颈癌筛查与生活在联邦贫困线以上或以下 300%（OR 2.69，95%CI 1.50，4.85）呈正相关。
定期获得医疗保健和医生是美洲原住民癌症筛查依从性最一致的预测因素，应成为提高这些社区筛查率活动的重点。
