School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Int J Health Policy Manag. 2016 Feb 12;5(6):365-71. doi: 10.15171/ijhpm.2016.14.
While colorectal cancer (CRC) is one of the most preventable causes of cancer mortality, it is one of the leading causes of cancer death in Canada where CRC screening uptake is suboptimal. Given the increased rate of mortality and morbidity among mental health patients, their condition could be a potential barrier to CRC screening due to greater difficulties in adhering to behaviours related to long-term health goals. Using a population-based study among Canadians, we hypothesize that self-perceived mental health (SPMH) status and fecal occult blood test (FOBT) uptake for the screening of CRC are associated.
The current study is cross-sectional and utilised data from the Canadian Community Health Survey 2011-2012. Multinomial logistic regression analysis was undertaken to assess whether SPMH is independently associated with FOBT uptake among a representative sample of 11 386 respondents aged 50-74 years.
Nearly half of the respondents reported having ever had FOBT for CRC screening, including 37.28% who have been screened within two years of the survey and 12.41% who had been screened more than two years preceding the survey. Respondents who reported excellent mental health were more likely to have ever been screened two years or more before the survey (adjusted odds ratio [AOR] = 2.08; 95% CI, 1.00-4.43) and to have been screened in the last two years preceding the survey (AOR = 1.53; 95% CI, 0.86-2.71) than those reported poor mental health status.
This study supports the association between SPMH status and FOBT uptake for CRC screening. While the efforts to maximize CRC screening uptake should be deployed to all eligible people, those with poor mental health may need more attention.
虽然结直肠癌(CRC)是最可预防的癌症死亡原因之一,但在加拿大,结直肠癌筛查的参与度不理想,因此它仍是导致癌症死亡的主要原因之一。鉴于精神健康患者的死亡率和发病率上升,他们的状况可能成为 CRC 筛查的潜在障碍,因为他们更难以坚持与长期健康目标相关的行为。本研究利用加拿大人群的一项基于人群的研究,假设自我感知的精神健康(SPMH)状况和粪便潜血试验(FOBT)对 CRC 的筛查参与率呈正相关。
本研究为横断面研究,利用了 2011-2012 年加拿大社区健康调查的数据。采用多项逻辑回归分析评估 SPMH 是否与代表性的 11386 名 50-74 岁受访者的 FOBT 筛查参与率独立相关。
近一半的受访者报告曾进行过 CRC 筛查的 FOBT,其中包括 37.28%的人在调查前两年内进行过筛查,12.41%的人在调查前两年以上进行过筛查。报告心理健康状况极佳的受访者更有可能在调查前两年或更早的时候进行过筛查(调整后的优势比[OR] = 2.08;95%可信区间,1.00-4.43),也更有可能在调查前两年内进行过筛查(OR = 1.53;95%可信区间,0.86-2.71)。
本研究支持 SPMH 状况与 CRC 筛查的 FOBT 参与率之间的关联。虽然应向所有符合条件的人推广最大限度提高 CRC 筛查参与率的努力,但那些心理健康状况较差的人可能需要更多关注。