International Health Program, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Institute of Public Health, National Yang Ming Chiao Tung University, No.155, Sec. 2, Linong St., Beitou District, Taipei City, 112, Taiwan.
Cancer Causes Control. 2023 Dec;34(12):1073-1084. doi: 10.1007/s10552-023-01758-z. Epub 2023 Jul 24.
Cancer is the second leading cause of death globally and in the U.S., but screening can reduce cancer-related deaths. We analyzed data from a nationwide survey to compare how sociodemographic factors were associated with never or not timely screening for multiple types of cancer, and the use of different colorectal cancer screening procedures.
We analyzed data from the 2019 U.S. National Health Interview Survey. To understand breast, cervical, and colorectal cancer screening participation among those recommended to screen, we respectively analyzed 8,110 women 45 to 74 years of age, 9,583 women 21 to 65 years of age, and 13,497 individuals 50 to 75 years of age at survey. Weighted Poisson regression was used to estimate the unadjusted and confounding-adjusted prevalence ratio and 95% confidence intervals.
In our analysis populations, 6.9% never had a mammogram, 14.6% never screened for cervical cancer, and 26.8% never screened for colorectal cancer; the prevalence respectively increased to 24.7%, 23.8%, and 32.3% for not timely screening according to national guidelines. The prevalence of never screening was 81.9% for non-invasive colorectal cancer tests, compared with 32.5% for colonoscopy or sigmoidoscopy. Individuals with lower education level, with no health insurance, or in poverty had higher prevalence of never screening for all three cancers. There was low sociodemographic disparity for the use of non-invasive colorectal cancer screening tests.
Socioeconomically disadvantaged individuals have higher prevalence of never or not timely screening. The utilization of non-invasive colorectal cancer screening procedures remains low across sociodemographic groups.
癌症是全球和美国的第二大死亡原因，但筛查可以降低癌症相关死亡率。我们分析了一项全国性调查的数据，比较了社会人口因素与多种癌症的从未筛查或未及时筛查之间的关系，以及不同结直肠癌筛查程序的使用情况。
我们分析了 2019 年美国国家健康访谈调查的数据。为了了解建议筛查的人群中乳腺癌、宫颈癌和结直肠癌的筛查参与情况，我们分别分析了 8110 名 45 至 74 岁的女性、9583 名 21 至 65 岁的女性和 13497 名 50 至 75 岁的个体。使用加权泊松回归估计未经调整和混杂因素调整后的患病率比和 95%置信区间。
在我们的分析人群中，6.9%的人从未进行过乳房 X 光检查，14.6%的人从未进行过宫颈癌筛查，26.8%的人从未进行过结直肠癌筛查；根据国家指南，未及时筛查的比例分别增加到 24.7%、23.8%和 32.3%。非侵入性结直肠癌检测的未筛查率为 81.9%，而结肠镜检查或乙状结肠镜检查的未筛查率为 32.5%。受教育程度较低、没有医疗保险或处于贫困状态的个体，三种癌症的未筛查率都较高。非侵入性结直肠癌筛查程序的使用在社会人口方面差异较小。
社会经济地位较低的个体未筛查或未及时筛查的比例较高。非侵入性结直肠癌筛查程序的利用率在社会人口群体中仍然较低。
