Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA, United States.
Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA, United States.
Prev Med. 2017 Dec;105:311-318. doi: 10.1016/j.ypmed.2017.10.012. Epub 2017 Oct 5.
Cancer screening patterns according to occupation characteristics in the United States are not well known, but could be used to help inform cancer control efforts. We examined cervical (CC), breast (BC) and colorectal cancer (CRC) screening prevalence and prevalence ratios (PR) by occupational characteristics in 2010, 2013 and 2015 National Health Interview Surveys (NHIS) among eligible US workers (CC women 21-65years; n=20,997), (BC women ≥40years; n=14,258) and (CRC men and women ≥50years; n=17,333). Cervical, breast and colorectal cancer screening prevalence among US workers was 84.0%, 68.9%, and 56.8%, respectively. Unadjusted prevalence ratios for cervical (PR=0.92, 95%CI 0.90, 0.94), breast (PR=0.86, 95%CI 0.83, 0.90) and colorectal cancer screening (PR=0.83, 95%CI 0.80, 0.87) were lower among workers in small (<25 employees) compared to large organizations (≥500 employees). People in food service, construction, production, and sales occupations were 13-26%, 17-28% and 9-30% less likely to be up to date with cervical, breast, and colorectal cancer screening, respectively, compared to healthcare professionals. Adjustment for socioeconomic factors and insurance status eliminated most associations. Disparities in cancer screening by occupational characteristics were mostly attributed to lower socioeconomic status and lack of insurance. These findings underscore the need for innovative public health strategies to improve cancer screening in vulnerable populations.
美国的癌症筛查模式根据职业特点而有所不同，但可以用来帮助为癌症控制工作提供信息。我们在 2010 年、2013 年和 2015 年的国家健康访谈调查（NHIS）中，根据职业特征检查了合格的美国工人中（CC 女性 21-65 岁；n=20997）、（BC 女性≥40 岁；n=14258）和（CRC 男性和女性≥50 岁；n=17333）中，宫颈癌（CC）、乳腺癌（BC）和结直肠癌（CRC）的筛查率和患病率比值（PR）。美国工人中宫颈癌、乳腺癌和结直肠癌的筛查率分别为 84.0%、68.9%和 56.8%。未经调整的宫颈癌（PR=0.92，95%CI 0.90，0.94）、乳腺癌（PR=0.86，95%CI 0.83，0.90）和结直肠癌筛查（PR=0.83，95%CI 0.80，0.87）的患病率比值在员工人数较少（<25 人）的小组织中低于员工人数较多（≥500 人）的大组织。与医疗保健专业人员相比，餐饮服务、建筑、生产和销售行业的人进行宫颈癌、乳腺癌和结直肠癌筛查的可能性分别低 13-26%、17-28%和 9-30%。调整社会经济因素和保险状况后，大多数关联都消失了。职业特点导致的癌症筛查差异主要归因于较低的社会经济地位和缺乏保险。这些发现强调需要创新公共卫生策略，以改善弱势群体的癌症筛查。
