社会人口特征与乳腺癌和结直肠癌筛查依从性的关系：大型亚人群分析。
The association between socio-demographic characteristics and adherence to breast and colorectal cancer screening: analysis of large sub populations.
机构信息
Quality Management in Health Care, Maccabi Healthcare Services, Tel-Aviv, Israel.
出版信息
BMC Cancer. 2011 Aug 25;11:376. doi: 10.1186/1471-2407-11-376.
BACKGROUND
Populations having lower socioeconomic status, as well as ethnic minorities, have demonstrated lower utilization of preventive screening, including tests for early detection of breast and colorectal cancer.
THE OBJECTIVE
To explore socio-demographic disparities in adherence to screening recommendations for early detection of cancer.
METHODS
The study was conducted by Maccabi Healthcare Services, an Israeli HMO (health plan) providing healthcare services to 1.9 million members. Utilization of breast cancer (BC) and colorectal cancer (CC) screening were analyzed by socio-economic ranks (SERs), ethnicity (Arab vs non-Arab), immigration status and ownership of voluntarily supplemental health insurance (VSHI).
RESULTS
Data on 157,928 and 303,330 adults, eligible for BC and CC screening, respectively, were analyzed. Those having lower SER, Arabs, immigrants from Former Soviet Union countries and non-owners of VSHI performed fewer cancer screening examinations compared with those having higher SER, non-Arabs, veterans and owners of VSHI (p < 0.001). Logistic regression model for BC Screening revealed a positive association with age and ownership of VSHI and a negative association with being an Arab and having a lower SER. The model for CC screening revealed a positive association with age and ownership of VSHI and a negative association with being an Arab, having a lower SER and being an immigrant. The model estimated for BC and CC screening among females revealed a positive association with age and ownership of VSHI and a negative association with being an Arab, having a lower SER and being an immigrant.
CONCLUSION
Patients from low socio-economic backgrounds, Arabs, immigrants and those who do not own supplemental insurance do fewer tests for early detection of cancer. These sub-populations should be considered priority populations for targeted intervention programs and improved resource allocation.
背景
社会经济地位较低的人群以及少数民族，其预防性筛查的利用率较低，包括用于早期发现乳腺癌和结直肠癌的检查。
目的
探讨社会人口统计学差异与癌症早期检测筛查建议的遵从性。
方法
该研究由 Maccabi 医疗保健服务机构（以色列 HMO，为 190 万成员提供医疗保健服务）进行。通过社会经济等级（SER）、族裔（阿拉伯裔与非阿拉伯裔）、移民身份和自愿补充健康保险（VSHI）的所有权，分析乳腺癌（BC）和结直肠癌（CC）筛查的利用情况。
结果
对分别符合 BC 和 CC 筛查条件的 157928 名和 303330 名成年人进行数据分析。与 SER 较高、非阿拉伯裔、退伍军人和 VSHI 所有者相比，SER 较低、阿拉伯裔、前苏联国家移民和非 VSHI 所有者进行的癌症筛查检查较少（p < 0.001）。BC 筛查的逻辑回归模型显示，年龄和 VSHI 的所有权与筛查呈正相关，而阿拉伯裔和 SER 较低则与筛查呈负相关。CC 筛查模型显示，年龄和 VSHI 的所有权与筛查呈正相关，而阿拉伯裔、SER 较低和移民与筛查呈负相关。BC 和 CC 筛查的女性模型显示，年龄和 VSHI 的所有权与筛查呈正相关，而阿拉伯裔、SER 较低和移民与筛查呈负相关。
结论
来自社会经济背景较低、阿拉伯裔、移民和没有补充保险的患者进行的癌症早期检测检查较少。这些亚人群应被视为有针对性的干预计划和资源分配改善的优先人群。
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