Rogers Charles R, Goodson Patricia, Foster Margaret J
University of Minnesota Medical School, Dept. of Family Medicine & Community Health, 717 Delaware St. SE, Suite 166, Minneapolis, MN 55414, Tel. 612-626-3894, Fax. 612-626-6782,
Texas A&M University, Dept. of Health & Kinesiology, TAMU 4243, College Station, TX 77843.
J Health Dispar Res Pract. 2015 Fall;8(3):133-156.
Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC's high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age < 50) African American men's intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men's screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies' methodological quality. Utilizing Garrard's Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS - ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions.
在影响男性和女性的癌症中，结直肠癌（CRC）是美国非裔美国人中第二大致命癌症。与白人男性相比，非裔美国男性患结直肠癌的发病率和死亡率分别高出25%和50%。尽管早期检测有益且有有效的筛查方法，但大多数50岁以上的成年人尚未接受检测，结直肠癌筛查（CRCS）方面的差异依然存在。由于非裔美国男性中结直肠癌的发病率高且发病年龄较轻，45岁而非50岁时就有必要进行CRCS。然而，尚未系统评估影响年轻成年（即年龄<50岁）非裔美国男性进行筛查的意愿和/或其CRCS行为的因素。为了评估影响年轻成年非裔美国男性筛查意愿和行为的因素是否可通过结构化健康教育干预来改变，我们进行了一项系统综述，其具有双重目的：（1）综合研究非裔美国男性关于CRCS的知识、信念和行为；（2）评估这些研究的方法学质量。利用加拉德矩阵法，共有28篇手稿符合我们的纳入/排除标准：20项研究采用非实验性研究设计，4项采用准实验设计，4项采用实验设计。研究发表于2002年至2012年之间；大多数发表于2007年至2011年之间。最常评估的因素是结直肠癌和CRCS的行为（79%）、信念（68%）和知识（61%）。出现了与结直肠癌和CRCS相关的六个因素：既往CRCS、结直肠癌检测偏好、感知益处、感知障碍、结直肠癌/CRCS知识以及医生支持/推荐。研究被赋予一个方法学质量评分（MQS - 范围从0到21）。平均MQS为10.9表明这些研究总体质量中等且存在特定缺陷。除了呼吁进行更严格的研究外，本综述还为实践和具有文化相关性的干预提供了重要建议。
