Department of Social Rehabilitation, Research Institute of National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa 359-8555, Japan.
Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuou 104-0045, Japan.
Int J Environ Res Public Health. 2024 Feb 13;21(2):219. doi: 10.3390/ijerph21020219.
Research on preventive healthcare services among people with disability in Japan is scarce. This study aimed to (1) examine the relationship between disability and the use of general health examination (GHE) and cancer screening (lung, gastric, colorectal, breast and cervical cancer) and (2) explore the reasons for not using GHE. This cross-sectional study used secondary data from individuals aged 20-74 years ( = 15,294) from the Comprehensive Survey of Living Conditions of 2016. Binomial logistic regression analysis was conducted to examine the relationship between disability and non-participation in preventive services. In addition, a descriptive analysis was conducted to explore the reasons for non-participation in GHE. Consequently, disability was identified as an independently associated factor for non-participation in GHE (odds ratios (OR): 1.73; 95% confidence interval (95%CI): 1.14-2.62) and screening for colorectal (OR: 1.78; 95%CI: 1.08-2.94), gastric (OR: 2.27; 95%CI: 1.27-4.05), cervical (OR: 2.12; 95%CI: 1.04-4.32) and breast cancer (OR: 2.22; 95%CI: 1.04-4.72), controlling for confounding factors. The most dominant reason for non-participation was "I can go to see the doctor anytime, if I am worried (25/54, 46.3%)." Our findings imply the existence of disability-based disparity in preventive healthcare service use in Japan.
日本针对残疾人群的预防保健服务研究相对较少。本研究旨在:(1) 考察残疾与一般健康检查(GHE)和癌症筛查(肺癌、胃癌、结直肠癌、乳腺癌和宫颈癌)使用之间的关系;(2) 探讨未使用 GHE 的原因。本横断面研究使用了 2016 年综合生活状况调查中 20-74 岁个体(n=15294)的二级数据。采用二项逻辑回归分析考察残疾与预防保健服务参与度之间的关系。此外,还进行了描述性分析,以探讨未参与 GHE 的原因。结果显示,残疾是 GHE 不参与(比值比(OR):1.73;95%置信区间(95%CI):1.14-2.62)和结直肠癌(OR:1.78;95%CI:1.08-2.94)、胃癌(OR:2.27;95%CI:1.27-4.05)、宫颈癌(OR:2.12;95%CI:1.04-4.32)和乳腺癌(OR:2.22;95%CI:1.04-4.72)筛查不参与的独立相关因素,控制了混杂因素。不参与的最主要原因是“如果我有担忧,我随时可以去看医生(25/54,46.3%)”。研究结果表明,日本在预防保健服务的使用上存在残疾相关的差异。