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评估费城及纽约市少数族裔人群中医生对乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)检测的建议。

Assessing Physicians' Recommendations for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Testing Among Minority Populations in Greater Philadelphia and New York City.

作者信息

Begum Thoin F, Patil Vidya S, Zhu Lin, Yeh Ming-Chin, González Evelyn, Fraser Marilyn A, Lu Wenyue, Zhu Steven, Rubio-Torio Nathaly, Ma Grace X, Tan Yin

机构信息

Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.

Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.

出版信息

J Community Health. 2024 Aug;49(4):588-597. doi: 10.1007/s10900-023-01316-3. Epub 2024 Jan 29.

Abstract

Deaths from liver cancer are on the rise and disproportionately affect minority racial/ethnic groups. In this study, we examined associations between physicians' recommendations for hepatitis B virus (HBV) and hepatitis C virus (HCV) screening and sociodemographic and lifestyle factors among minority populations in the areas of Greater Philadelphia and New York City. Using Poisson regression with robust variance estimation, we evaluated potential associations for 576 Hispanic American (HA), African American (AA), and Asian Pacific American (APA) adults, using blood tests as an outcome measure, with adjustment for sociodemographic factors We found that APAs (34.2%) were most likely to have a physician recommend HBV and HCV screening tests (34.2% and 27.1%, respectively), while HAs were least likely to receive an HBV recommendation (15.0%) and AAs were least likely to receive an HCV recommendation (15.3%). HAs were significantly likely to have never received a blood test for either HBV or HCV (RR = 1.25, 95% CI: 1.05, 1.49). APAs were significantly more likely to receive a screening recommendation for HBV (RR = 1.10, 95%CI: 1.01, 1.20) and to have a blood test (RR = 1.57, 95% CI: 1.06, 2.33). Our findings show that, among HAs, AAs, and APAs, physician recommendations are strongly associated with patients undergoing blood tests for HBV and HCV and that minority populations should increasingly be recommended to screen for HBV and HCV, especially given their elevated risk.

摘要

肝癌导致的死亡人数正在上升,且对少数种族/族裔群体的影响尤为严重。在本研究中,我们调查了大费城地区和纽约市少数族裔人群中医生对乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)筛查的建议与社会人口统计学和生活方式因素之间的关联。我们使用具有稳健方差估计的泊松回归,以血液检测作为结果指标,对576名西班牙裔美国人(HA)、非裔美国人(AA)和亚太裔美国人(APA)成年人进行了潜在关联评估,并对社会人口统计学因素进行了调整。我们发现,亚太裔美国人(34.2%)最有可能得到医生对HBV和HCV筛查检测的建议(分别为34.2%和27.1%),而西班牙裔美国人得到HBV检测建议的可能性最小(15.0%),非裔美国人得到HCV检测建议的可能性最小(15.3%)。西班牙裔美国人从未接受过HBV或HCV血液检测的可能性显著更高(RR = 1.25,95% CI:1.05,1.49)。亚太裔美国人得到HBV筛查建议(RR = 1.10,95%CI:1.01,1.20)和进行血液检测(RR = 1.57,95% CI:1.06,2.33)的可能性显著更高。我们的研究结果表明,在西班牙裔美国人、非裔美国人和亚太裔美国人中,医生的建议与患者接受HBV和HCV血液检测密切相关,鉴于少数族裔人群风险较高,应越来越多地建议他们进行HBV和HCV筛查。

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