Department of Health Services, University of California at Los Angeles, Los Angeles, California, USA.
Cancer. 2012 Mar 15;118(6):1656-63. doi: 10.1002/cncr.26480. Epub 2011 Aug 25.
Understanding racial/ethnic disparities in cancer screening by family history risk could identify critical opportunities for patient and provider interventions tailored to specific racial/ethnic groups. The authors evaluated whether breast cancer (BC) and colorectal cancer (CRC) disparities varied by family history risk using a large, multiethnic population-based survey.
By using the 2005 California Health Interview Survey, BC and CRC screening were evaluated separately with weighted multivariate regression analyses, and stratified by family history risk. Screening was defined for BC as mammogram within the past 2 years for women aged 40 to 64 years; for CRC, screening was defined as annual fecal occult blood test, sigmoidoscopy within the past 5 years, or colonoscopy within the past 10 years for adults aged 50 to 64 years.
The authors found no significant BC screening disparities by race/ethnicity or income in the family history risk groups. Racial/ethnic disparities were more evident in CRC screening, and the Latino-white gap widened among individuals with family history risk. Among adults with a family history for CRC, the magnitude of the Latino-white difference in CRC screening (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.11-0.60) was more substantial than that for individuals with no family history (OR, 0.74; 95% CI, 0.59-0.92).
Knowledge of their family history widened the Latino-white gap in CRC screening among adults. More aggressive interventions that enhance the communication between Latinos and their physicians about family history and cancer risk could reduce the substantial Latino-white screening disparity in Latinos most susceptible to CRC.
通过家族史风险了解癌症筛查中的种族/民族差异，可以为针对特定种族/民族群体的患者和提供者干预措施确定关键机会。作者评估了使用大型多族裔人群为基础的调查，通过家族史风险评估乳腺癌（BC）和结直肠癌（CRC）筛查是否存在差异。
作者使用 2005 年加利福尼亚健康访谈调查，分别使用加权多元回归分析，以及按家族史风险分层，对 BC 和 CRC 筛查进行评估。BC 的筛查定义为 40 至 64 岁女性在过去 2 年内进行乳房 X 光检查；CRC 的筛查定义为 50 至 64 岁成年人每年进行粪便潜血试验、过去 5 年内进行乙状结肠镜检查或过去 10 年内进行结肠镜检查。
作者发现，在家族史风险组中，种族/民族或收入与 BC 筛查之间没有显著差异。在 CRC 筛查中，种族/民族差异更为明显，并且在有家族史风险的个体中，拉丁裔与白人之间的差距扩大。在有 CRC 家族史的成年人中，CRC 筛查中拉丁裔与白人差异的幅度（比值比 [OR]，0.28；95%置信区间 [CI]，0.11-0.60）大于没有家族史的个体（OR，0.74；95%CI，0.59-0.92）。
了解家族史会扩大有家族史风险的成年人中 CRC 筛查的拉丁裔与白人之间的差距。更积极的干预措施可以增强拉丁裔人与医生之间关于家族史和癌症风险的沟通，从而减少最易患 CRC 的拉丁裔人群中巨大的拉丁裔与白人筛查差异。
