Bellizzi Keith M, Breslau Erica S, Burness Allison, Waldron William
Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269, USA.
Arch Intern Med. 2011 Dec 12;171(22):2031-7. doi: 10.1001/archinternmed.2011.570.
While a great deal is known about cancer screening behaviors and trends in young and middle-aged adults, little is known about screening behaviors in older adults from different racial backgrounds. Our goal was to establish prevalence estimates and correlates of cancer screening, including physician recommendation in older (≥75 years), racially diverse adults.
Data were analyzed from the National Health Interview Survey--an annual, in-person, nationwide survey used to track health trends in US civilians. The analytic sample included 49,575 individuals, of whom 1697 were 75 to 79 years old and 2376 were 80 years or older. Screening behaviors were examined according to the US Preventive Services Task Force recommendations for breast, cervical, colorectal, and prostate cancer screening.
Among adults aged 75 to 79 years, the percentage screened for cancer was as follows: colorectal, 57%; breast, 62%; cervical, 53%; and prostate, 56%. Among those 80 years or older, rates of screening ranged from a low of 38% for cervical cancer to a high of 50% for breast cancer. Although unadjusted screening prevalence rates differed by race/ethnicity, these differences were accounted for by low education attainment in the multivariate logistic regression model. Physician recommendation for a specific test was the largest predictor of screening. Over 50% of men and women older than 75 years report that their physicians continue to recommend screening.
A high percentage of older adults continue to be screened in the face of ambiguity of recommendations for this group.
虽然我们对年轻和中年成年人的癌症筛查行为及趋势了解很多,但对于不同种族背景的老年人的筛查行为却知之甚少。我们的目标是确定老年(≥75岁)、种族多样的成年人中癌症筛查的患病率估计值及其相关因素,包括医生的建议。
对美国国家健康访谈调查的数据进行分析,该调查是一项年度的、面对面的全国性调查,用于跟踪美国平民的健康趋势。分析样本包括49575人,其中1697人年龄在75至79岁之间,2376人年龄在80岁及以上。根据美国预防服务工作组关于乳腺癌、宫颈癌、结直肠癌和前列腺癌筛查的建议,对筛查行为进行了检查。
在75至79岁的成年人中,进行癌症筛查的百分比分别为:结直肠癌57%;乳腺癌62%;宫颈癌53%;前列腺癌56%。在80岁及以上的人群中,筛查率从宫颈癌的38%到乳腺癌的50%不等。尽管未经调整的筛查患病率因种族/族裔而异,但在多变量逻辑回归模型中,这些差异是由低教育程度造成的。医生对特定检查的建议是筛查的最大预测因素。超过50%的75岁以上男性和女性报告称,他们的医生继续建议进行筛查。
面对针对该群体建议的不明确性,仍有很高比例的老年人继续接受筛查。