Centre for International Health, Curtin University, GPO Box U1987, Perth, Western Australia.
BMC Public Health. 2012 Jul 18;12:528. doi: 10.1186/1471-2458-12-528.
Indigenous Australians are significantly less likely to participate in colorectal cancer (CRC) screening compared to non-Indigenous people. This study aimed to identify important factors influencing the decision to undertake screening using Faecal Occult Blood Testing (FOBT) among Indigenous Australians. Very little evidence exists to guide interventions and programmatic approaches for facilitating screening uptake in this population in order to reduce the disparity in colorectal cancer outcomes.
Interviewer-administered surveys were carried out with a convenience sample (n = 93) of Indigenous Western Australians between November 2009-March 2010 to assess knowledge, awareness, attitudes and behavioural intent in regard to CRC and CRC screening.
Awareness and knowledge of CRC and screening were low, although both were significantly associated with exposure to media advertising (p = 0.008; p < 0.0001). Nearly two-thirds (63%; 58/92) of respondents reported intending to participate in screening, while a greater proportion (84%; 77/92) said they would participate on a doctor's recommendation. Multivariate analysis with logistic regression demonstrated that independent predictors of screening intention were, greater perceived self-efficacy (OR = 19.8, 95% CI = 5.5-71.8), a history of cancer screening participation (OR = 6.8, 95% CI = 2.0-23.3) and being aged 45 years or more (OR = 4.5, 95% CI = 1.2-16.5). A higher CRC knowledge score (medium vs. low: OR = 9.9, 95% CI = 2.4-41.3; high vs. low: 13.6, 95% CI = 3.4-54.0) and being married or in a de-facto relationship (OR = 6.9, 95% CI = 2.1-22.5) were also identified as predictors of intention to screen with FOBT.
Improving CRC related knowledge and confidence to carry out the FOBT self-screening test through education and greater promotion of screening has the potential to enhance Indigenous participation in CRC screening. These findings should guide the development of interventions to encourage screening uptake and reduce bowel cancer related deaths among Indigenous Australians.
与非原住民相比，澳大利亚原住民参与结直肠癌（CRC）筛查的可能性显著较低。本研究旨在确定影响使用粪便潜血检测（FOBT）进行筛查决定的重要因素，以提高该人群的筛查参与度，从而减少结直肠癌结果的差异。
2009 年 11 月至 2010 年 3 月，对西澳大利亚州的 93 名澳大利亚原住民进行了方便样本的访谈式调查，以评估他们对 CRC 和 CRC 筛查的知识、意识、态度和行为意向。
尽管媒体广告的接触（p = 0.008；p < 0.0001）与 CRC 和筛查的意识和知识显著相关，但对 CRC 和筛查的意识和知识均较低。近三分之二（63%；58/92）的受访者表示打算参加筛查，而更多的受访者（84%；77/92）表示会在医生的建议下参加筛查。多元逻辑回归分析显示，筛查意向的独立预测因素包括，更大的自我效能感（OR = 19.8，95%CI = 5.5-71.8）、有癌症筛查参与史（OR = 6.8，95%CI = 2.0-23.3）和年龄在 45 岁或以上（OR = 4.5，95%CI = 1.2-16.5）。更高的 CRC 知识得分（中 vs. 低：OR = 9.9，95%CI = 2.4-41.3；高 vs. 低：OR = 13.6，95%CI = 3.4-54.0）和已婚或事实关系（OR = 6.9，95%CI = 2.1-22.5）也被确定为 FOBT 筛查意向的预测因素。
通过教育和更多地宣传来提高与 CRC 相关的知识和信心，以进行 FOBT 自我筛查测试，有可能提高原住民参与 CRC 筛查的积极性。这些发现应该指导制定干预措施，以鼓励筛查参与，减少澳大利亚原住民的结直肠癌相关死亡。
