Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.
National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Cancer. 2018 Mar 1;124(5):907-915. doi: 10.1002/cncr.31145. Epub 2017 Nov 22.
Screening with the fecal immunochemical test (FIT) is effective in reducing deaths from colorectal cancer (CRC). Since 2004, biennial FIT screening has been available to a target population in Taiwan as a national screening program. The objective of the current study was to identify the factors that influence willingness to undergo a confirmatory colonoscopy after a positive FIT, because related references in the published literature were scarce.
A semistructured questionnaire was based on the Health Belief Model (HBM) and a literature review. A stratified, random sampling method was used to recruit participants who had a positive FIT from all cities/counties in Taiwan. Cross-sectional, computer-assisted telephone interviews were conducted in 2012, and the results were analyzed using a logistic regression model that took into account population demographics, core content of the HBM, and HBM-modifying variables.
In total, 2807 respondents were included in the analysis. The completion rate was 50%. Multivariate analyses revealed that higher perceived threat (adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 1.31-2.01), higher cues for action (aOR, 2.18; 95% CI, 1.68-1.82), lower perceived barriers (aOR, 0.42; 95% CI, 0.34-0.42) and higher health behavior scores (aOR, 1.30; 95% CI, 1.05-1.60) were associated with a greater willingness to participate in confirmatory colonoscopy. Participants who were older (aOR, 0.74; 95% CI, 0.55-0.98) or unmarried (aOR, 0.72; 95% CI, 0.56-0.92) were less likely to participate in verification.
The government could improve the screening rate by training case managers to assist in following patients until they complete colonoscopy, subsidizing sedated colonoscopies, and providing health education not only to the general public but also to physicians. Cancer 2018;124:907-15. © 2017 American Cancer Society.
粪便免疫化学检测（FIT）筛查可有效降低结直肠癌（CRC）的死亡率。自 2004 年以来，台湾的一个目标人群已作为国家筛查计划接受了每两年一次的 FIT 筛查。本研究的目的是确定影响阳性 FIT 后接受确认性结肠镜检查意愿的因素，因为相关文献中的参考资料很少。
半结构问卷基于健康信念模型（HBM）和文献回顾。采用分层随机抽样方法，从台湾所有市县招募阳性 FIT 的参与者。2012 年进行了横断面、计算机辅助电话访谈，并使用考虑人口统计学、HBM 的核心内容和 HBM 修正变量的逻辑回归模型进行分析。
共纳入 2807 名受访者进行分析。完成率为 50%。多变量分析显示，感知威胁增加（调整优势比[aOR]，1.62；95%置信区间[CI]，1.31-2.01）、行动线索增加（aOR，2.18；95%CI，1.68-1.82）、感知障碍降低（aOR，0.42；95%CI，0.34-0.42）和健康行为评分升高（aOR，1.30；95%CI，1.05-1.60）与更愿意进行确认性结肠镜检查相关。年龄较大（aOR，0.74；95%CI，0.55-0.98）或未婚（aOR，0.72；95%CI，0.56-0.92）的参与者不太可能参加验证。
政府可以通过培训病例管理人员来协助患者完成结肠镜检查，补贴镇静结肠镜检查，并不仅向公众而且向医生提供健康教育，从而提高筛查率。癌症 2018；124：907-15。©2017 美国癌症协会。
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