Division of Hospital Medicine, Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Turk J Gastroenterol. 2022 Nov;33(11):901-908. doi: 10.5152/tjg.2022.21567.
Barriers to colorectal cancer screening persist despite screening campaigns, especially among women. This study explores the prevalence, preferences, and barriers associated with colorectal cancer screening and evaluates the effect of an inpatient intervention (one-on-one bedside education and handout about colorectal cancer) on screening adherence among hospitalized women.
A prospective intervention study among 510 hospitalized women, who are cancer-free (except for skin cancer) at enrollment, aged between 50 and 75 years was conducted at an academic center. Socio-demographic, family history, and medical comorbidities data were collected for all patients. A post-hospitalization follow-up survey determined the effect of inpatient intervention on colorectal cancer screening adherence. Unpaired t-test and chi-square tests were used to compare characteristics, perspectives, and preferences for screening among adherent and non-adherent groups.
Mean age was 60.5 years, 45% reported an annual household income of <$20 000, 36% of women were African American, 27% of women were overdue for colorectal cancer screening, and 33% never had a screening colonoscopy. The most frequently reported barriers to colorectal cancer screening were "I have other problems more important than getting a colonoscopy," "No transportation to get to the test," and "Not counseled by primary care provider." Sixty-six percent of the non-adherent women would agree to have an inpatient screening colonoscopy if offered.
A significant number of hospitalized women are non-adherent to colorectal cancer screening, while the educational intervention was partially successful in enhancing colorectal cancer screening, most hospitalized women remained non-adherent after hospitalization. A majority of these women were amenable to inpatient screening colonoscopy if offered during a hospital stay.
尽管开展了筛查活动，但结直肠癌筛查的障碍仍然存在，尤其是在女性中。本研究旨在探讨结直肠癌筛查的流行率、偏好和障碍，并评估住院女性中一项住院干预（一对一床边教育和结直肠癌宣传单）对筛查依从性的影响。
在一家学术中心，对 510 名无癌症（除皮肤癌外）的 50-75 岁住院女性进行了前瞻性干预研究。对所有患者进行了社会人口统计学、家族史和合并症数据的收集。出院后的随访调查确定了住院干预对结直肠癌筛查依从性的影响。采用独立样本 t 检验和卡方检验比较了依从组和不依从组的特征、对筛查的看法和偏好。
平均年龄为 60.5 岁，45%的患者报告年收入<20000 美元，36%的女性为非裔美国人，27%的女性未及时进行结直肠癌筛查，33%的女性从未进行过筛查性结肠镜检查。结直肠癌筛查的最常见障碍是“我有比做结肠镜检查更重要的问题”、“没有交通工具去做检查”和“没有被初级保健提供者建议”。66%的不依从女性如果提供，愿意接受住院筛查结肠镜检查。
相当数量的住院女性不依从结直肠癌筛查，而教育干预在增强结直肠癌筛查方面部分成功，但大多数住院女性在出院后仍不依从。如果在住院期间提供，大多数这些女性愿意接受住院筛查结肠镜检查。
