National Cancer Institute, Bethesda, Maryland.
9606 Medical Center Dr, MSC 9762, Bethesda, MD 20892-9762.E-mail:
Prev Chronic Dis. 2014 Feb 27;11:E29. doi: 10.5888/pcd11.130174.
Healthy People (HP) is the US program that formulates and tracks national health objectives for the nation. The National Health Interview Survey (NHIS) is a designated data source for setting and evaluating several HP targets in cancer. We used data from the 2008 and 2010 NHIS to provide a benchmark for national performance toward meeting HP 2020 cancer-related objectives.
HP 2020 cancer screening, provider counseling, and health care access objectives were selected. For each objective, NHIS measures for the overall population and several sociodemographic subgroups were calculated; the findings were compared with established HP 2020 targets.
From 2008 to 2010, rates of breast and cervical cancer screening declined slightly while colorectal cancer screening rates increased by 7 percentage points. Rates of cancer screening and provider counseling were below HP targets. Meeting HP targets seems less likely for subgroups characterized by low income, no health insurance, or no usual source of care. Meeting HP targets for access to health services will require an increase of 18 percentage points in the proportion of persons under age 65 with health insurance coverage and an increase of 10 percentage points in the proportion aged 18 to 64 with a usual source of care.
Whether HP objectives for cancer screening and health care access are met may depend on implementation of health care reform measures that improve access to and coordination of care. Better integration of clinical health care and community-based efforts for delivering high-quality screening and treatment services and elimination of health disparities are also needed.
《健康人民》（HP）是美国制定和跟踪国家健康目标的计划。国家健康访谈调查（NHIS）是为设定和评估癌症方面的几个 HP 目标指定的数据来源。我们使用了 2008 年和 2010 年 NHIS 的数据，为实现 HP 2020 年癌症相关目标的国家绩效提供了一个基准。
选择了 HP 2020 年癌症筛查、提供者咨询和医疗保健获取目标。对于每个目标，计算了 NHIS 对总体人群和几个社会人口统计学亚组的衡量标准；将结果与既定的 HP 2020 目标进行比较。
从 2008 年到 2010 年，乳腺癌和宫颈癌筛查率略有下降，而结直肠癌筛查率增加了 7 个百分点。癌症筛查和提供者咨询率低于 HP 目标。收入低、没有医疗保险或没有常规医疗服务来源的亚组更不可能达到 HP 目标。要达到 HP 目标，需要将 65 岁以下人群的医疗保险覆盖率提高 18 个百分点，将 18 至 64 岁人群的常规医疗服务来源比例提高 10 个百分点。
HP 癌症筛查和医疗保健获取目标的实现情况可能取决于改善医疗保健获取和协调的医疗改革措施的实施情况。还需要更好地整合临床医疗保健和社区努力，提供高质量的筛查和治疗服务，并消除健康差异。
