Laiyemo Adeyinka O, Adebogun Akeem O, Doubeni Chyke A, Ricks-Santi Luisel, McDonald-Pinkett Shelly, Young Patrick E, Cash Brooks D, Klabunde Carrie N
Department of Medicine, Howard University College of Medicine, Washington, DC, USA; Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Department of Medicine, Howard University College of Medicine, Washington, DC, USA.
Prev Med. 2014 Oct;67:1-5. doi: 10.1016/j.ypmed.2014.06.022. Epub 2014 Jun 23.
It is unclear if provider recommendations regarding colorectal cancer (CRC) screening modalities affect patient compliance. We evaluated provider-patient communications about CRC screening with and without a specific screening modality recommendation on patient compliance with screening guidelines.
We used the 2007 Health Information National Trends Survey (HINTS) and identified 4283 respondents who were at least 50 years of age and answered questions about their communication with their care providers and CRC screening uptake. We defined being compliant with CRC screening as the use of fecal occult blood testing (FOBT) within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years. We used survey weights in all analyses.
CRC screening discussions occurred with 3320 (76.2%) respondents. Approximately 95% of these discussions were with physicians. Overall, 2793 (62.6%) respondents were current with CRC screening regardless of the screening modality. Discussion about screening (odds ratio (OR)=8.83; 95% confidence interval (CI): 7.20-10.84) and providers making a specific recommendation about screening modality rather than leaving it to the patient to decide (OR=2.04; 95% CI: 1.54-2.68) were associated with patient compliance with CRC screening guidelines.
Compliance with CRC screening guidelines is improved when providers discuss options and make specific screening test recommendations.
医疗服务提供者关于结直肠癌（CRC）筛查方式的建议是否会影响患者的依从性尚不清楚。我们评估了医疗服务提供者与患者之间关于CRC筛查的沟通情况，以及有无特定筛查方式建议对患者遵循筛查指南情况的影响。
我们使用了2007年全国健康信息趋势调查（HINTS），确定了4283名年龄至少为50岁且回答了有关其与医疗服务提供者沟通及CRC筛查接受情况问题的受访者。我们将遵循CRC筛查定义为在1年内使用粪便潜血试验（FOBT）、5年内使用乙状结肠镜检查或10年内使用结肠镜检查。我们在所有分析中都使用了调查权重。
3320名（76.2%）受访者进行了CRC筛查讨论。其中约95%的讨论是与医生进行的。总体而言，2793名（62.6%）受访者目前正在进行CRC筛查，无论筛查方式如何。关于筛查的讨论（优势比（OR）=8.83；95%置信区间（CI）：7.20 - 10.84）以及医疗服务提供者就筛查方式提出具体建议而非让患者自行决定（OR = 2.04；95% CI：1.54 - 2.68）与患者遵循CRC筛查指南相关。
当医疗服务提供者讨论筛查选项并提出具体的筛查测试建议时，患者对CRC筛查指南的遵循情况会得到改善。
