North Campus Research Complex, 2800 Plymouth Road, Building 16, 4th Floor, Ann Arbor, MI 48109, USA.
Cancer Epidemiol Biomarkers Prev. 2013 Jun;22(6):1037-42. doi: 10.1158/1055-9965.EPI-12-1215. Epub 2013 Apr 29.
Previous research has shown colorectal cancer (CRC) screening disparities by gender. Little research has focused primarily on gender differences among older Black individuals, and reasons for existing gender differences remain poorly understood.
We used baseline data from the Cancer Prevention and Treatment Demonstration Screening Trial. Participants were recruited from November 2006 to March 2010. In-person interviews were used to assess self-reported CRC screening behavior. Up-to-date CRC screening was defined as self-reported colonoscopy or sigmoidoscopy in the past 10 years or fecal occult blood testing in the past year. We used multivariable logistic regression to examine the association between gender and self-reported screening, adjusting for covariates. The final model was stratified by gender to examine factors differentially associated with screening outcomes for males and females.
The final sample consisted of 1,552 female and 586 male Black Medicare beneficiaries in Baltimore, Maryland. Males were significantly less likely than females to report being up-to-date with screening (77.5% vs. 81.6%, P = 0.030), and this difference was significant in the fully adjusted model (OR: 0.72; 95% confidence interval, 0.52-0.99). The association between having a usual source of care and receipt of cancer screening was stronger among males compared with females.
Although observed differences in CRC screening were small, several factors suggest that gender-specific approaches may be used to promote screening adherence among Black Medicare beneficiaries.
Given disproportionate CRC mortality between White and Black Medicare beneficiaries, gender-specific interventions aimed at increasing CRC screening may be warranted among older Black patients.
先前的研究表明，结直肠癌（CRC）筛查存在性别差异。很少有研究主要关注老年黑人个体中的性别差异，并且对现有性别差异的原因仍知之甚少。
我们使用了癌症预防和治疗示范筛查试验的基线数据。参与者是在 2006 年 11 月至 2010 年 3 月期间招募的。通过面对面访谈来评估自我报告的 CRC 筛查行为。最新的 CRC 筛查定义为过去 10 年内自我报告的结肠镜检查或乙状结肠镜检查，或过去 1 年内粪便潜血检测。我们使用多变量逻辑回归来检查性别与自我报告的筛查之间的关联，并调整了协变量。最后模型按性别分层，以检查与男性和女性筛查结果相关的因素。
最终样本包括马里兰州巴尔的摩的 1552 名女性和 586 名男性黑人医疗保险受益人。男性报告接受筛查的比例明显低于女性（77.5%对 81.6%，P=0.030），在完全调整后的模型中，这种差异具有统计学意义（OR：0.72；95%置信区间，0.52-0.99）。与有常规医疗来源相比，癌症筛查的获得与男性之间的关联比女性更强。
尽管 CRC 筛查的差异很小，但有几个因素表明，可能需要针对黑人医疗保险受益人的特定性别方法来促进筛查的依从性。
鉴于白人和黑人医疗保险受益人间 CRC 死亡率的差异很大，因此针对老年黑人患者，可能需要开展针对特定性别的干预措施来增加 CRC 筛查。
