Central Michigan University College of Medicine, 1280 S. East Campus St, Mt. Pleasant, MI, 48859, USA.
J Racial Ethn Health Disparities. 2018 Aug;5(4):901-906. doi: 10.1007/s40615-017-0438-x. Epub 2017 Nov 3.
The objective of this study was to investigate the various factors that influence colorectal cancer screening in Michigan using 6091 participants in the Michigan Behavioral Risk Factor Surveillance System representing adults ≥ 50 years old.
Screening for colorectal cancer was assessed as fecal occult blood testing or colonoscopy/sigmoidoscopy. Full models simultaneously adjusted for alcohol use, angina/coronary heart disease, stroke, heart attack, gender, income, marital status, race, age, diabetes, disability, exercise, health care coverage, health care access, smoking, and mental health. Data analysis included cross-tabulation and logistic regression modeling.
Minorities were 1.3 (unadjusted odds ratio; 95% confidence interval = 1.03-1.57) times more likely to never have a colonoscopy/sigmoidoscopy than non-Hispanic whites. Race/ethnicity was not significant in the full model, but adults with the following characteristics were significantly (p < 0.05) more likely to never have a colonoscopy/sigmoidoscopy: no personal doctor/health care provider, no health care coverage, light alcohol consumption ≤ 25% of days, no alcohol consumption, low income < $15,000, 50-64 years old, no diabetes, no activity limitation, no exercise, smoked daily, and smoked some days.
The racial disparity in colorectal cancer screening in Michigan was explained by other characteristics. The healthcare community can work to eliminate racial disparities in colorectal cancer screening by increasing screening efforts for individuals with these characteristics.
本研究的目的是使用密歇根行为风险因素监测系统中的 6091 名≥50 岁的成年人来调查影响密歇根州结直肠癌筛查的各种因素。
结直肠癌筛查评估为粪便潜血检测或结肠镜检查/乙状结肠镜检查。全模型同时调整了饮酒、心绞痛/冠心病、中风、心脏病发作、性别、收入、婚姻状况、种族、年龄、糖尿病、残疾、运动、医疗保险覆盖范围、医疗保健获取、吸烟和心理健康。数据分析包括交叉制表和逻辑回归建模。
少数民族（未经调整的优势比；95%置信区间=1.03-1.57）进行结肠镜检查/乙状结肠镜检查的可能性比非西班牙裔白人低 1.3 倍。种族/民族在全模型中并不显著，但具有以下特征的成年人进行结肠镜检查/乙状结肠镜检查的可能性显著降低（p<0.05）：没有私人医生/医疗保健提供者、没有医疗保险、饮酒量≤25%、不饮酒、低收入<15,000 美元、50-64 岁、没有糖尿病、没有活动受限、没有运动、每天吸烟和偶尔吸烟。
密歇根州结直肠癌筛查的种族差异可以用其他特征来解释。医疗保健界可以通过增加具有这些特征的个体的筛查力度，努力消除结直肠癌筛查中的种族差异。
