Singh Harminder, Bernstein Charles N, Samadder Jewel N, Ahmed Rashid
IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Man. ; Internal Medicine, University of Manitoba, Winnipeg, Man. ; Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Man.
IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Man. ; Internal Medicine, University of Manitoba, Winnipeg, Man.
CMAJ Open. 2015 Apr 2;3(2):E149-57. doi: 10.9778/cmajo.20140073. eCollection 2015 Apr-Jun.
Implementation of population-based colorectal cancer (CRC) screening programs should reduce disparities in participation in CRC screening. We estimated CRC screening rates in 2012 in Canada and assessed predictors of screening in provinces with and without well-established population-based screening programs.
We used data from the Canadian Community Health Survey for 2012 to calculate the prevalence of up-to-date CRC screening, defined as fecal occult blood testing (FOBT) within 2 years before the survey or flexible sigmoidoscopy or colonoscopy within 10 years before the survey, or both. Weighted proportions of individuals with up-to-date screening were calculated and logistic regression analysis performed to assess predictors of up-to-date CRC screening, including differences in participation by income level.
The prevalence of up-to-date CRC screening among people 50-74 years of age in 2012 was 55.2%, ranging from 41.3% in the territories to 67.2% in the province of Manitoba. The rate for sigmoidoscopy or colonoscopy was 37.2% (highest in Ontario, at 43.3%), and for FOBT it was 30.1% (highest in Manitoba, at 51.7%). About 41% of those who had an FOBT also had a sigmoidoscopy or colonoscopy. Individuals in the highest income group were more likely than those in lower-income groups to be up to date with CRC screening, even in provinces with well-established population-based screening programs.
More than half of Canadians were up to date with CRC screening in 2012, but there were large differences among provinces. Differences by income group in provinces with population-based screening programs need particular attention.
实施基于人群的结直肠癌（CRC）筛查项目应能减少CRC筛查参与率方面的差异。我们估算了2012年加拿大的CRC筛查率，并评估了有无成熟的基于人群筛查项目的省份中筛查的预测因素。
我们使用2012年加拿大社区健康调查的数据来计算最新CRC筛查的患病率，定义为在调查前2年内进行粪便潜血试验（FOBT），或在调查前10年内进行乙状结肠镜检查或结肠镜检查，或两者皆有。计算最新筛查个体的加权比例，并进行逻辑回归分析以评估最新CRC筛查的预测因素，包括按收入水平划分的参与差异。
2012年50 - 74岁人群中最新CRC筛查的患病率为55.2%，范围从各地区的41.3%到曼尼托巴省的67.2%。乙状结肠镜检查或结肠镜检查的比例为37.2%（安大略省最高，为43.3%），FOBT的比例为30.1%（曼尼托巴省最高，为51.7%）。进行FOBT的人群中约41%也进行了乙状结肠镜检查或结肠镜检查。即使在有成熟的基于人群筛查项目的省份，最高收入组的个体比低收入组的个体更有可能进行最新的CRC筛查。
2012年超过一半的加拿大人进行了最新的CRC筛查，但各省之间存在很大差异。在有基于人群筛查项目的省份中，按收入组划分的差异需要特别关注。
