The National Cancer Institute, Rockville, Maryland.
The National Cancer Institute, Rockville, Maryland.
Am J Prev Med. 2018 May;54(5):699-703. doi: 10.1016/j.amepre.2018.02.002. Epub 2018 Mar 16.
Appreciating the accuracy and value of cancer screening is essential to informed decision making about screening. This study's objectives were to (1) examine people's beliefs about the accuracy and value of cancer screening, and (2) determine whether sociodemographics, cancer beliefs, and shared decision making are associated with these beliefs.
Data from the National Cancer Institute's Health Information National Trends Survey (cycle 4, August-November 2014) were used. Respondents were non-institutionalized adults (aged ≥18 years, n=3,677). Weighted generalized linear modeling was used to examine bivariate and multivariate associations between key covariates and beliefs about cancer screening (assessed by four-item scale and independently). Secondary analyses examined whether these beliefs were associated with self-reported cancer screening. Data were analyzed between 2016 and 2017.
Only 5.6% (n=189) of respondents answered all four cancer screening items correctly. Men, racial/ethnic minorities, and those with lower education and higher cancer fatalism were less likely to have accurate beliefs about cancer screening. However, those who reported shared decision making for colorectal cancer screening were more likely to know that "when a test finds something abnormal, more tests are needed to know if it is cancer" and "when a test finds something abnormal, it is [not] very likely to be cancer" (adjusted risk ratio=1.13, p<0.01, adjusted risk ratio=1.25, p<0.01). Beliefs were not associated with likelihood of past mammography or Pap testing.
Educators, researchers, and clinicians should consider opportunities (e.g., through shared decision making) to improve the accuracy of individuals' beliefs about cancer screening.
了解癌症筛查的准确性和价值对于做出有关筛查的知情决策至关重要。本研究的目的是:(1) 研究人们对癌症筛查准确性和价值的看法;(2) 确定社会人口统计学、癌症信念和共同决策是否与这些信念相关。
使用国家癌症研究所健康信息国家趋势调查(第 4 周期,2014 年 8 月至 11 月)的数据。受访者为非机构化成年人(年龄≥18 岁,n=3677)。使用加权广义线性模型,在单变量和多变量关联之间检查关键协变量与癌症筛查信念(通过四项量表独立评估)之间的关系。二次分析检验这些信念是否与自我报告的癌症筛查有关。数据分析于 2016 年至 2017 年进行。
只有 5.6%(n=189)的受访者正确回答了所有四项癌症筛查项目。男性、少数族裔和教育程度较低、癌症宿命论较高的人不太可能对癌症筛查有准确的信念。然而,那些报告共同参与结直肠癌筛查的人更有可能知道“当测试发现异常时,需要进行更多测试以确定是否为癌症”和“当测试发现异常时,不太可能是癌症”(调整后的风险比=1.13,p<0.01,调整后的风险比=1.25,p<0.01)。信念与过去进行乳房 X 线摄影或巴氏试验的可能性无关。
教育工作者、研究人员和临床医生应考虑通过共同决策等机会来提高个人对癌症筛查准确性的信念。