The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
Department of Global Health, School of Public Health, Peking University, Beijing, China.
Eur J Cancer Care (Engl). 2021 Mar;30(2):e13369. doi: 10.1111/ecc.13369. Epub 2020 Nov 17.
This study aimed to evaluate how the knowledge and perception towards colorectal cancer (CRC) screening had been changed in a large population, and identified factors associated with its participation based on factors pertinent to the Health Belief Model (HBM).
Data from 3600 screening participants and 3600 non-participants were collected through a telephone survey via simple random sampling of telephone numbers in a territory-wide directory from December 2016 to November 2018. Sociodemographic factors; the enabling factors of screening as well as the barriers of screening were collected. The changes in these factors were evaluated by Pearson's chi-square trend test. A logistic regression model was constructed to identify the association between the above factors and CRC screening participation.
The knowledge level (67.9% to 85.4%, p < 0.001), perceived severity of having CRC (37.7%-42.8%, p < 0.01), perceived benefits of screening (54.9%-72.1%, p < 0.001), and reductions in barriers (14.1%-5.1%, p < 0.001) of CRC screening significantly improved among the non-users. Subjects with older age (adjusted odds ratio (AOR): 2.01, p < 0.001), higher knowledge level of screening methods (AOR: 6.68, p < 0.001), greater perceived severity (AOR: 2.04, p < 0.001) and coverage of insurance (AOR: 1.22, p < 0.01) were more likely to participate. In contrast, more affluent subjects (AOR: 0.69, p < 0.001), female individuals (AOR: 0.63, p < 0.001), higher level of perceived psychological (AOR: 0.54, p < 0.001) and access barriers (AOR: 0.55, p < 0.001) were associated with poorer participation.
These findings demonstrated a substantial increase in the enabling factors of CRC screening, including knowledge, perceived severity and perceived benefits. The study also identified the target groups such as younger individuals, females and more affluent people among whom more intensive educational initiatives are needed to enhance their participation.
本研究旨在评估在大规模人群中，人们对结直肠癌（CRC）筛查的知识和认知有何变化，并根据与健康信念模型（HBM）相关的因素，确定与其参与相关的因素。
本研究于 2016 年 12 月至 2018 年 11 月期间，通过简单随机抽样电话号码，对电话簿中的 3600 名筛查参与者和 3600 名非参与者进行了电话调查，收集了社会人口统计学因素、筛查的促成因素以及筛查的障碍因素。通过皮尔逊卡方趋势检验评估这些因素的变化。构建逻辑回归模型，以确定上述因素与 CRC 筛查参与之间的关联。
非使用者的 CRC 筛查知识水平（67.9%至 85.4%，p<0.001）、对 CRC 发生严重程度的认知（37.7%至 42.8%，p<0.01）、对筛查益处的认知（54.9%至 72.1%，p<0.001）以及对筛查障碍的认知（14.1%至 5.1%，p<0.001）均显著提高。年龄较大（调整后的优势比（AOR）：2.01，p<0.001）、对筛查方法知识水平较高（AOR：6.68，p<0.001）、对严重性认知较高（AOR：2.04，p<0.001）、保险覆盖范围较广（AOR：1.22，p<0.01）的受试者更有可能参与筛查。相反，较富裕的受试者（AOR：0.69，p<0.001）、女性（AOR：0.63，p<0.001）、对心理（AOR：0.54，p<0.001）和获得性障碍认知较高（AOR：0.55，p<0.001）的受试者参与筛查的可能性较低。
这些发现表明 CRC 筛查的促进因素，包括知识、对严重性的认知和对益处的认知，有了显著增加。该研究还确定了目标人群，如年轻人、女性和较富裕的人群，需要针对这些人群开展更密集的教育活动，以提高他们的参与度。
