Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
J Cancer Surviv. 2021 Apr;15(2):234-243. doi: 10.1007/s11764-020-00927-2. Epub 2020 Aug 10.
This study aimed to evaluate factors associated with pneumococcal vaccination uptake (PVU) of cancer survivors.
A total of 2032 Korean adult cancer survivors diagnosed between June of 1975 and February of 2018 have participated. Information on PVU status and selected variables were collected through self-administered questionnaires and medical record review. Factors associated PVU were investigated using multiple logistic regression analysis.
PVU rate markedly differed by age strata and cancer sites: 73.9% for elderly (≥ 65 years) survivors and 34.6% for younger (< 65 years) survivors and 73.4% for lung cancer survivors and 42.1% for non-lung cancer survivors. Regular physical exercise was associated with higher PVU in both age groups: Odds ratio (OR) and 95% confidence interval (CI) were 1.52 (1.20, 1.94) for younger and 1.78 (1.09, 2.90) for elderly survivors. Complementary medication use was positively associated with PVU with borderline significance in both age groups. However, the association of PVU with other factors differed between the two age groups. In younger survivors, a positive association with PVU was evident for longer time lapse after cancer diagnosis, chronic disease, and living with spouse/or partner, while cancer stage, educational achievement, and alcohol use were inversely associated PVU. On the other hand, multi-modality (≥ 3) cancer treatment was inversely associated with PVU only in elderly survivors.
PVU of Korean cancer survivors was suboptimal in younger survivors and non-lung cancer survivors. Factors associated with PVU differed between younger and elderly survivors, and more diverse factors were identified for younger survivors.
In order to promote adherence to PVU in cancer survivors, careful consideration of high-risk factors for non-immunization within cancer survivorship context would be necessary together with free-of-charge vaccination policy.
本研究旨在评估与癌症幸存者肺炎球菌疫苗接种率（PVU）相关的因素。
共纳入 2032 名于 1975 年 6 月至 2018 年 2 月期间确诊的韩国成年癌症幸存者。通过自填式问卷和病历回顾收集 PVU 状态和选定变量的信息。使用多因素 logistic 回归分析调查与 PVU 相关的因素。
PVU 率在年龄和癌症部位上有明显差异：老年（≥65 岁）幸存者为 73.9%，年轻（<65 岁）幸存者为 34.6%；肺癌幸存者为 73.4%，非肺癌幸存者为 42.1%。对于两个年龄组，定期进行身体锻炼与更高的 PVU 相关：年轻组的比值比（OR）和 95%置信区间（CI）为 1.52（1.20，1.94），老年组为 1.78（1.09，2.90）。补充药物的使用与 PVU 呈正相关，在两个年龄组中均具有边缘显著性。然而，PVU 与其他因素的关联在两个年龄组之间有所不同。在年轻幸存者中，PVU 与癌症诊断后时间间隔较长、慢性病和与配偶/伴侣同住呈正相关，而癌症分期、教育程度和饮酒则与 PVU 呈负相关。另一方面，在老年幸存者中，仅多模式（≥3 种）癌症治疗与 PVU 呈负相关。
韩国癌症幸存者的 PVU 率在年轻幸存者和非肺癌幸存者中较低。与 PVU 相关的因素在年轻和老年幸存者之间有所不同，并且年轻幸存者中确定了更多不同的因素。
为了促进癌症幸存者对 PVU 的依从性，在癌症生存背景下，需要仔细考虑非免疫接种的高危因素，并实施免费接种政策。
