Perisetti Abhilash, Khan Hafiz, George Nayana E, Yendala Rachana, Rafiq Aamrin, Blakely Summre, Rasmussen Drew, Villalpando Nathan, Goyal Hemant
Department of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.
Department of Public Health, Texas Tech University Health Sciences, Lubbock, TX 79430, United States.
World J Gastrointest Pharmacol Ther. 2018 Sep 5;9(4):31-38. doi: 10.4292/wjgpt.v9.i4.31.
To describe the characteristics of adults who needed to see a doctor in the past year but could not due to the extra cost and assess the impact of limited financial resources on the receipt of routine fecal occult blood test, sigmoidoscopy, or colonoscopy for colon cancer screening among insured patients.
Data obtained from the 2012 Behavioral Risk Factor Surveillance System included 215436 insured adults age 50-75 years. We computed frequencies, adjusted odds ratios (aORs), and 95%CIs using SAS v9.3 software.
Nine percent of the study population needed to see a doctor in the past year but could not because of cost. The numbers were significantly higher among those aged 50-64 ( < 0.0001), Non-Hispanic Whites ( < 0.0001), and those with a primary care physician ( < 0.0001) among other factors. Adjusting for possible confounders, aORs for not seeing the doctor in the past year because of cost were: stool occult blood test within last year aOR = 0.88; 95%CI: 0.76-1.02, sigmoidoscopy within last year aOR = 0.72; 95%CI: 0.48-1.07, colonoscopy within the last year aOR = 0.91; 95%CI: 0.81-1.02.
We found that the limited financial resources within the past 12 mo were significantly associated with colorectal cancer (CRC) non-screening. Patients with risk factors identified in this study should adhere to CRC guidelines and should receive financial help if needed.
描述过去一年中因费用过高而需要就医但未能就医的成年人的特征，并评估有限的财政资源对参保患者接受用于结肠癌筛查的常规粪便潜血试验、乙状结肠镜检查或结肠镜检查的影响。
从2012年行为危险因素监测系统获得的数据包括215436名年龄在50 - 75岁的参保成年人。我们使用SAS v9.3软件计算频率、调整后的优势比（aORs）和95%置信区间（CIs）。
9%的研究人群在过去一年中因费用问题需要就医但未能就医。在50 - 64岁人群（<0.0001）、非西班牙裔白人（<0.0001）以及有初级保健医生的人群（<0.0001）等其他因素中，这一数字显著更高。在对可能的混杂因素进行调整后，过去一年因费用未就医的aORs为：去年进行粪便潜血试验aOR = 0.88；95%CI：0.76 - 1.02，去年进行乙状结肠镜检查aOR = 0.72；95%CI：0.48 - 1.07，去年进行结肠镜检查aOR = 0.91；95%CI：0.81 - 1.02。
我们发现过去12个月内有限的财政资源与结直肠癌（CRC）未筛查显著相关。本研究中确定的有风险因素的患者应遵循CRC指南，并在需要时获得财政帮助。
