Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Cancer. 2012 Jan 15;118(2):478-84. doi: 10.1002/cncr.26315. Epub 2011 Jul 12.
Screening by fecal occult blood test and lower endoscopy has lowered colorectal cancer (CRC) mortality, but compliance gaps persist. Of concern are possible disparities in uptake of CRC screening between white and African American men. The goal of this study was to assess for disparities in uptake of CRC screening among men participating in a high-risk prostate cancer clinic. If present, such disparities could support hypotheses for further research examining racial differences in awareness and patient preferences in undergoing CRC screening.
Baseline data on a racially diverse cohort of men aged 50 to 69 years at increased risk of prostate cancer collected via the Prostate Cancer Risk Assessment Program at Fox Chase Cancer Center were analyzed. Predictors of uptake of CRC screening were assessed using multivariate logistic regression.
Compared with whites, African American men had statistically significantly lower uptake of fecal occult blood testing (African American 49.0% vs white 60.7%, P = .035), lower endoscopy (African American 44.1% vs white 58.5%, P = .011), and any CRC screening (African American 66.2% vs white 76.3%, P = .053). Predictors of uptake of lower endoscopy among African American men included older age (odds ratio [OR], 3.61; 95% confidence interval [CI], 1.87-6.97), family history of CRC (OR, 3.47; 95% CI, 1.30-9.25), and insurance status (OR, 1.90; 95% CI, 1.04-3.46).
Despite awareness of cancer risk and motivation to seek prostate cancer screening through a specialized prostate cancer risk assessment program, evidence supporting compliance gaps with CRC screening among men was found. Tailored messages to younger African American men with and without a family history of CRC are needed.
粪便潜血试验和下内窥镜检查降低了结直肠癌（CRC）的死亡率，但仍存在依从性差距。令人担忧的是，白人和非裔美国男性之间 CRC 筛查的接受程度可能存在差异。本研究的目的是评估参加高危前列腺癌诊所的男性中 CRC 筛查的接受程度是否存在差异。如果存在这种差异，可以支持进一步研究种族差异在接受 CRC 筛查方面的意识和患者偏好的假设。
分析了通过 Fox Chase Cancer Center 的前列腺癌风险评估计划收集的、年龄在 50 至 69 岁之间、患有前列腺癌风险增加的、种族多样化男性队列的基线数据。使用多变量逻辑回归评估 CRC 筛查接受度的预测因素。
与白人相比，非裔美国男性的粪便潜血检测（非裔美国人 49.0%，白人 60.7%，P =.035）、内窥镜检查（非裔美国人 44.1%，白人 58.5%，P =.011）和任何 CRC 筛查（非裔美国人 66.2%，白人 76.3%，P =.053）的接受率均明显较低。非裔美国男性接受内窥镜检查的预测因素包括年龄较大（优势比[OR]，3.61；95%置信区间[CI]，1.87-6.97）、CRC 家族史（OR，3.47；95% CI，1.30-9.25）和保险状况（OR，1.90；95% CI，1.04-3.46）。
尽管通过专门的前列腺癌风险评估计划意识到癌症风险并积极寻求前列腺癌筛查，但仍发现男性 CRC 筛查的依从性存在差距。需要针对有或没有 CRC 家族史的年轻非裔美国男性制定有针对性的信息。
