Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Kyoto 606-8501, Japan.
Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
Cancer Epidemiol. 2020 Dec;69:101798. doi: 10.1016/j.canep.2020.101798. Epub 2020 Sep 24.
Multimorbidity is associated with a high mortality rate and low health-related quality of life. Previous studies have indicated that multimorbidity tends to be associated with not receiving cancer screening, although this association remains unclear. This study aimed to investigate the associations between multimorbidity and the delivery of breast, cervical, and colorectal cancer screening in Japan, and to identify subgroups that did not receive cancer screening.
This study used cross-sectional data from the 2016 Comprehensive Survey of Living Conditions, which used a stratified random sample of the general Japanese population. Multivariable logistic regression models were used to evaluate the associations between the number of chronic conditions and each cancer's screening proportion. The relevant covariates included age, marital status, education level, occupation, and household income.
Relative to subjects with no chronic conditions, subjects with two chronic conditions received more screening for breast, cervical, and colorectal cancers (breast cancer, adjusted odds ratio [aOR]: 5.42, 95% confidence interval [CI]: 2.80-10.5; cervical cancer, aOR: 4.59, 95% CI: 2.03-10.4; male colorectal cancer, aOR: 3.26, 95% CI: 1.29-8.24; female colorectal cancer, aOR: 1.05, 95% CI: 0.39-2.81). Low socioeconomic status was associated with not receiving any type of cancer screening consistently.
Multimorbidity and high socioeconomic status were associated with higher proportions of screening for breast, cervical, and colorectal cancers in the Japanese population. More aggressive strategies may be needed to promote screening among Japanese individuals with no chronic conditions and individuals with low socioeconomic status.
多种疾病与高死亡率和低健康相关生活质量相关。先前的研究表明，多种疾病往往与未接受癌症筛查有关，尽管这种关联尚不清楚。本研究旨在调查日本多种疾病与乳腺癌、宫颈癌和结直肠癌筛查之间的关系，并确定未接受癌症筛查的亚组。
本研究使用了 2016 年综合生活状况调查的横断面数据，该调查采用了日本一般人群的分层随机抽样。使用多变量逻辑回归模型评估了慢性疾病数量与每种癌症筛查比例之间的关系。相关协变量包括年龄、婚姻状况、教育程度、职业和家庭收入。
与无慢性疾病的受试者相比，有两种慢性疾病的受试者接受了更多的乳腺癌、宫颈癌和结直肠癌筛查（乳腺癌，调整后的优势比 [aOR]：5.42，95%置信区间 [CI]：2.80-10.5；宫颈癌，aOR：4.59，95% CI：2.03-10.4；男性结直肠癌，aOR：3.26，95% CI：1.29-8.24；女性结直肠癌，aOR：1.05，95% CI：0.39-2.81）。低社会经济地位与所有类型的癌症筛查均未得到一致相关。
多种疾病和高社会经济地位与日本人群中乳腺癌、宫颈癌和结直肠癌筛查比例较高相关。可能需要更积极的策略来促进无慢性疾病和低社会经济地位的日本个体进行筛查。
