Moran Ryan J, Waalen Jill, Murphy James, Nalawade Vinit, Schiaffino Melody
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States.
School of Public Health, San Diego State University, San Diego, CA, United States.
JMIR Public Health Surveill. 2019 May 13;5(2):e12603. doi: 10.2196/12603.
Colorectal cancer (CRC) is the second leading cancer-related cause of death in the United States. However, survivorship has been increasing. Both cancer survivors and underserved populations experience unique health-related challenges and disparities that may exist among long-term CRC survivors as it relates to routine preventive care, specifically pneumococcal (PNM) vaccination.
The aim of this study was to explore the relationship between long-term CRC survival and the receipt of PNM vaccine among Hispanic Medicare recipients compared with non-Hispanic populations.
This study is a cross-sectional analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare claims data examining ethnic differences in the receipt of PNM vaccination among long-term CRC survivors. Multivariable logistic regression models considered Hispanic ethnicity while controlling for sociodemographic characteristics, comorbidity score, age, tumor stage, and SEER registry.
Our sample revealed 32,501 long-term CRC survivors, and 1509 identified as Hispanic (4.64%) based on an established SEER algorithm. In total, 16,252 CRC survivors, or 50.00% of our sample, received a PNM vaccination. We found that Hispanic CRC survivors had 10% decreased odds of having received a PNM vaccine compared with non-Hispanic survivors (P=.03).
Disparities likely exist in the utilization of PNM vaccination among long-term CRC survivors. Among Medicare beneficiaries, the use of claims data regarding PNM vaccination highlights the relatively poor utilization of guideline-directed preventive care.
在美国,结直肠癌(CRC)是癌症相关死亡的第二大主要原因。然而,生存率一直在提高。癌症幸存者和服务不足的人群都面临着与健康相关的独特挑战和差异,这些差异可能存在于长期CRC幸存者中,涉及常规预防性护理,特别是肺炎球菌(PNM)疫苗接种。
本研究的目的是探讨西班牙裔医疗保险受益人与非西班牙裔人群相比,长期CRC生存与PNM疫苗接种之间的关系。
本研究是对监测、流行病学和最终结果(SEER)-医疗保险索赔数据的横断面分析,研究长期CRC幸存者中PNM疫苗接种的种族差异。多变量逻辑回归模型在控制社会人口学特征、合并症评分、年龄、肿瘤分期和SEER登记处的同时考虑了西班牙裔种族。
我们的样本显示有32,501名长期CRC幸存者,根据既定的SEER算法,有1509人被确定为西班牙裔(4.64%)。总共有16,252名CRC幸存者,即我们样本的50.00%,接受了PNM疫苗接种。我们发现,与非西班牙裔幸存者相比,西班牙裔CRC幸存者接种PNM疫苗的几率降低了10%(P = 0.03)。
长期CRC幸存者在PNM疫苗接种的使用方面可能存在差异。在医疗保险受益人中,使用关于PNM疫苗接种的索赔数据凸显了指南指导的预防性护理的相对较差的利用率。