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美国佐治亚州粪便潜血检测用于结直肠癌筛查的评估

Evaluation of Blood Stool Test Utilization for Colorectal Cancer Screening in Georgia, USA.

作者信息

Ansa Benjamin E, Lewis Nicollette, Hoffman Zachary, Datta Biplab, Johnson J Aaron

机构信息

Institute of Public and Preventive Health, Augusta University, Augusta, GA 30912, USA.

Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.

出版信息

Healthcare (Basel). 2021 May 12;9(5):569. doi: 10.3390/healthcare9050569.

Abstract

Colorectal cancer (CRC) is the third most prevalent cancer and the second most common cause of cancer-related deaths in the United States (USA). Early screening has been demonstrated to improve clinical outcomes for CRC. Assessing patterns in CRC screening utilization is important for guiding policy and implementing programs for CRC prevention and control. This study examines the trends and sociodemographic factors associated with blood stool test utilization (BSTU) for CRC screening in Georgia, USA. The Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed for Average Annual Percent Change (AAPC) in BSTU between 1997 and 2014 among adults aged 50+ who have had a blood stool test within the past two years, and logistic regression analysis of the 2016 data was performed to identify the associated sociodemographic factors. In Georgia, an overall decrease was observed in BSTU, from 27.8% in 1997 to 16.1% in 2014 (AAPC = -2.6, = 0.023). The decrease in BSTU was less pronounced in Georgia than nationally (from 26.1% in 1997 to 12.8% in 2014 (AAPC = -4.5, < 0.001)). BSTU was significantly associated with black race/ethnicity (Black vs. White (aOR = 1.43, = 0.015)), older age (≥70 vs. 50-59 (aOR = 1.62, = 0.006)), having insurance coverage (no vs. yes (aOR = 0.37 = 0.005)), and lower income (≥USD 50,000 vs. <USD 25,000 (aOR = 0.70 = 0.050)). These findings reveal a decrease over time in BSTU in Georgia, with existing differences between sociodemographic groups. Understanding these patterns helps in directing tailored programs for promoting CRC screening, especially among disadvantaged populations.

摘要

结直肠癌(CRC)是美国第三大常见癌症,也是癌症相关死亡的第二大常见原因。早期筛查已被证明可改善结直肠癌的临床结局。评估结直肠癌筛查利用率的模式对于指导政策制定和实施结直肠癌预防控制项目至关重要。本研究调查了美国佐治亚州与用于结直肠癌筛查的粪便潜血试验利用率(BSTU)相关的趋势和社会人口学因素。分析了行为危险因素监测系统(BRFSS)数据,以了解1997年至2014年期间50岁及以上成年人中在过去两年内进行过粪便潜血试验的人群的BSTU年均变化百分比(AAPC),并对2016年的数据进行逻辑回归分析,以确定相关的社会人口学因素。在佐治亚州,BSTU总体呈下降趋势,从1997年的27.8%降至2014年的16.1%(AAPC = -2.6,P = 0.023)。佐治亚州BSTU的下降幅度不如全国明显(从1997年的26.1%降至2014年的12.8%(AAPC = -4.5,P < 0.001))。BSTU与黑人种族/族裔(黑人与白人相比(调整后比值比[aOR]=1.43,P = 0.015))、年龄较大(≥70岁与50 - 59岁相比(aOR = 1.62,P = 0.006))、有保险覆盖(无保险与有保险相比(aOR = 0.37,P = 0.005))以及收入较低(≥50,000美元与<25,000美元相比(aOR = 0.70,P = 0.050))显著相关。这些发现揭示了佐治亚州BSTU随时间的下降,且社会人口学群体之间存在现有差异。了解这些模式有助于指导针对性的项目以促进结直肠癌筛查,特别是在弱势群体中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e45f/8151945/8286b813a56f/healthcare-09-00569-g001.jpg

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