Koczkodaj Paweł, Camacho Fabian, Batten George P, Anderson Roger T
Cancer Epidemiology and Primary Prevention Department, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
Comprehensive Cancer Center, University of Virginia, Charlottesville, VA 22903, USA.
Cancers (Basel). 2022 Sep 1;14(17):4296. doi: 10.3390/cancers14174296.
Background: Cancer is one of the leading causes of death among Polish women in general, and first in women aged 25−64. Contributing to this cancer burden are modifiable behavioral risk factors, including low utilization of cancer screenings. Poland has an urgent need for new systemic solutions that will decrease cancer burden in the female Polish population. This study examined the United States’ implementation of preventive wellness visits as a viable solution for implementation in Poland. Methods: Health insurance claims data for nearly three million women in five states of the U.S. were examined to identify use of mammograms, colorectal cancer screening, and lung cancer screening. Three subgroups of the cohort were assessed for the probability of receipt of screening associated with type of healthcare visit history (women with wellness visits—W; with wellness visits and related preventive services and screenings—W+P; and control group—C). All multiple comparisons were significant (alpha = 0.05) at p < 0.0001, except comparison between subgroups (W vs. P+W) for lung cancer screening. Results: Breast and colorectal cancer screenings had substantially higher participation after W and W+P in comparison with C; moreover, a slight increase after W or P+W was seen for lung cancer as well. Conclusions: Results indicate that wellness visits are an effective tool for increasing cancer screening among women in the U.S. Introduction of a similar solution in Poland could potentially help produce higher screening rates, address cancer prevention needs (not only for secondary cancer prevention), and lower cancer burden.
癌症是波兰女性总体上主要的死亡原因之一,在25 - 64岁女性中位列第一。可改变的行为风险因素,包括癌症筛查利用率低,加剧了这种癌症负担。波兰迫切需要新的系统性解决方案来减轻波兰女性群体的癌症负担。本研究考察了美国实施预防性健康检查作为在波兰实施的可行解决方案。方法:对美国五个州近三百万女性的医疗保险理赔数据进行检查,以确定乳房X光检查、结直肠癌筛查和肺癌筛查的使用情况。根据医疗就诊历史类型评估该队列的三个亚组接受筛查的概率(有健康检查的女性—W;有健康检查及相关预防服务和筛查的女性—W + P;以及对照组—C)。除肺癌筛查亚组(W与P + W)之间的比较外,所有多重比较在p < 0.0001时均具有显著性(α = 0.05)。结果:与C组相比,W组和W + P组之后乳腺癌和结直肠癌筛查的参与率大幅更高;此外,W组或P + W组之后肺癌筛查也略有增加。结论:结果表明健康检查是提高美国女性癌症筛查率的有效工具。在波兰引入类似的解决方案可能有助于提高筛查率,满足癌症预防需求(不仅是二级癌症预防),并减轻癌症负担。