Philip Errol J, Shelton Rachel C, Thompson Hayley S, Efuni Elizaveta, Itzkowitz Steven, Jandorf Lina
Memorial Sloan Kettering Cancer Center, 641 Lexington Street, 7th Floor, New York, NY, 10022, USA,
Cancer Causes Control. 2014 Sep;25(9):1227-31. doi: 10.1007/s10552-014-0415-1. Epub 2014 Jun 20.
The association between excess body weight and colorectal cancer screening is not well established. The purpose of this analysis was to explore, in the context of patients receiving navigation, whether obesity influences receipt of screening colonoscopy among lower-income Latinos and African Americans.
This sub-analysis was conducted among Latinos and African American participants who received patient navigation and had complete body mass index (BMI) data (n = 520). Cross-sectional survey data were collected at baseline among individuals 50 years and older who were referred by their primary care providers for a colonoscopy at Mount Sinai's Primary Care Clinic. BMI was based on height and weight data from chart review at baseline, and colonoscopy completion status was collected at 1 year post-baseline.
The mean BMI of the sample was 31.17 kg/m(2), with over half (53 %) of the sample categorized as obese. Rates of colonoscopy screening were high (~80 %), regardless of weight status. Adjusting for age, gender, race/ethnicity, family history of colorectal cancer, smoking status, comorbid conditions, income, marital status, insurance, and education, obesity status was not significantly associated with screening behavior among the entire sample (adjusted OR 0.81, CI 0.49-1.32, p = 0.39) or among stratified race/ethnicity and gender groups.
These findings suggest that obesity may not negatively influence receipt of colonoscopy screening in the context of patient navigation among minority participants. Further studies are needed to determine whether this finding will be observed in other populations, with and without the assistance of a patient navigator.
超重与结直肠癌筛查之间的关联尚未完全明确。本分析的目的是探讨在接受导航服务的患者中，肥胖是否会影响低收入拉丁裔和非裔美国人接受结肠镜筛查的情况。
对接受患者导航服务且有完整体重指数（BMI）数据的拉丁裔和非裔美国参与者进行了这项亚分析（n = 520）。在基线时收集了50岁及以上、由其初级保健提供者转介至西奈山初级保健诊所进行结肠镜检查的个体的横断面调查数据。BMI基于基线时病历审查中的身高和体重数据，结肠镜检查完成状态在基线后1年收集。
样本的平均BMI为31.17kg/m²，超过一半（53%）的样本被归类为肥胖。无论体重状况如何，结肠镜筛查率都很高（约80%）。在调整了年龄、性别、种族/族裔、结直肠癌家族史、吸烟状况、合并症、收入、婚姻状况、保险和教育程度后，肥胖状况与整个样本（调整后的OR为0.81，CI为0.49 - 1.32，p = 0.39）或分层的种族/族裔和性别组中的筛查行为均无显著关联。
这些发现表明，在少数族裔参与者接受患者导航服务的情况下，肥胖可能不会对结肠镜筛查的接受情况产生负面影响。需要进一步研究以确定在有或没有患者导航员协助的情况下，其他人群是否也会观察到这一发现。
