Myers R E, Trock B J, Lerman C, Wolf T, Ross E, Engstrom P F
Division of Population Science, Fox Chase Cancer Center, Cheltenham, Pennsylvania 19012.
Prev Med. 1990 Sep;19(5):502-14. doi: 10.1016/0091-7435(90)90049-p.
This study aimed to determine factors that influence fecal occult blood test performance in colorectal cancer screening. A random sample was selected of men and women ages 50 to 74 years of age who had been mailed a fecal occult blood testing kit in a screening program in fall 1986. One year after initial test mailing, sample group members (n = 504) were surveyed by telephone. Four months later, the survey sample received a second fecal occult blood test mailing. Multivariable analysis for subjects with validated past fecal occult blood test status (n = 322) revealed the past testing was positively associated with physician encouragement of screening, age, the belief that cancer is curable, perceived test efficacy, and strong intention to do testing. It also was discovered that persons who felt that they had little control over their health were more likely to have done past testing. Preliminary analysis of prospective adherence showed that the strongest statistically significant independent predictor was past test performance. Prospective adherence among past nontesters (n = 121) was associated with expressed commitment to do fecal occult blood testing and reported presence of colorectal cancer risk factors. Analysis of adherence among past testers (n = 201) revealed that belief in colorectal cancer curability and age were significant predictors. The findings reported here indicate that factors influencing adherence among past nontesters differ from those for past testers. Overall, these results suggest that to increase participation in colorectal cancer screening, physicians and other health professionals should (a) deliver educational messages that increase awareness of risk factors for colorectal cancer and curability of the disease, and (b) elicit from potential screenees a commitment to engage in recommended preventive behaviors. It may also be well to consider "tailoring" messages for past nontesters and past testers, respectively, by emphasizing colorectal cancer risk factors and highlighting curability.
本研究旨在确定影响结直肠癌筛查中粪便潜血试验效果的因素。从1986年秋季一项筛查项目中收到粪便潜血检测试剂盒的50至74岁男性和女性中随机抽取样本。在首次邮寄检测试剂盒一年后，通过电话对样本组成员（n = 504）进行了调查。四个月后，调查样本收到了第二次粪便潜血试验试剂盒邮寄。对过去粪便潜血试验状态得到验证的受试者（n = 322）进行多变量分析发现，过去的检测与医生对筛查的鼓励、年龄、癌症可治愈的信念、感知到的检测效果以及强烈的检测意愿呈正相关。还发现，认为自己对健康几乎没有控制权的人更有可能进行过过去的检测。对前瞻性依从性的初步分析表明，统计学上最显著的独立预测因素是过去的检测表现。过去未进行检测者（n = 121）中的前瞻性依从性与表示愿意进行粪便潜血检测以及报告存在结直肠癌风险因素有关。对过去进行过检测者（n = 201）的依从性分析表明，对结直肠癌可治愈性的信念和年龄是显著的预测因素。此处报告的研究结果表明，影响过去未进行检测者依从性的因素与过去进行过检测者不同。总体而言，这些结果表明，为了提高结直肠癌筛查的参与率，医生和其他卫生专业人员应：（a）传递教育信息，提高对结直肠癌风险因素和疾病可治愈性的认识；（b）促使潜在筛查对象承诺采取推荐的预防行为。分别针对过去未进行检测者和过去进行过检测者“量身定制”信息可能也有好处，即对前者强调结直肠癌风险因素，对后者突出可治愈性。
