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确定美国西班牙裔/拉丁裔人群结直肠癌筛查干预措施的优先事项。

Identification of Priorities for Colorectal Cancer Screening Interventions Among US Hispanic/Latino Populations.

机构信息

R. Blake Buchalter is with the Center for Populations Health Research, Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH. Mariana C. Stern and Joel Sanchez Mendez are with the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA. Michelle K. Kim is with the Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic. Johnie Rose is with the Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland. Cathy D. Meade and Clement K. Gwede are with the Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. Jane C. Figueiredo is with the Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles. Stephanie L. Schmit is with the Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic.

出版信息

Am J Public Health. 2024 Jul;114(S6):S515-S524. doi: 10.2105/AJPH.2024.307733.

Abstract

To identify nationwide census tract‒level areas where improving colorectal cancer (CRC) screening uptake via targeted local preventive intervention may benefit Hispanic or Latino/a (H/L) groups defined by region or country of origin. Using 2021 Centers for Disease Control and Prevention PLACES and American Community Survey data, we applied geographically weighted regression and Getis-Ord Gi* hot spot procedures to identify CRC screening priority zones for H/L groups in the United States. Priority zones can be conceptualized as census tracts with strong inverse associations between percentage of a particular H/L group in the population and CRC screening rate, after adjusting for socioeconomic deprivation and lack of insurance. We identified 6519, 3477, 3522, 1069, and 1424 census tract CRC screening priority zones for H/L communities of Mexican, Puerto Rican, Central/South American, Dominican, and Cuban heritage, respectively. Priority zones for H/L groups had strong spatial heterogeneity, and overlap of geographic patterns among H/L groups varied by region. Our findings and interactive web map may serve as a translational tool for public health authorities, policymakers, clinicians, and other stakeholders to target investment and interventions to increase guideline-concordant CRC screening uptake benefitting specific H/L communities in the United States. (. 2024;114(S6):S515-S524. https://doi.org/10.2105/AJPH.2024.307733) [Formula: see text].

摘要

为了确定全国范围内的普查区层面区域,通过有针对性的地方预防干预措施提高结直肠癌(CRC)筛查的参与度,可能会使以地区或原籍国为定义的西班牙裔或拉丁裔/(H/L)人群受益。我们使用 2021 年疾病控制和预防中心的 PLACES 和美国社区调查数据,应用地理加权回归和 Getis-Ord Gi*热点程序,确定了美国 H/L 人群的 CRC 筛查优先区域。优先区域可以被概念化为人口中特定 H/L 群体比例与 CRC 筛查率之间存在强烈负相关的普查区,在调整了社会经济剥夺和缺乏保险等因素后。我们确定了 6519、3477、3522、1069 和 1424 个分别针对墨西哥裔、波多黎各裔、中/南美裔、多米尼加裔和古巴裔 H/L 社区的 CRC 筛查优先普查区。H/L 群体的优先区域具有很强的空间异质性,并且 H/L 群体之间的地理模式重叠程度因地区而异。我们的发现和交互式网络地图可以作为公共卫生当局、政策制定者、临床医生和其他利益相关者的翻译工具,以针对特定的 H/L 社区进行投资和干预,从而提高符合指南的 CRC 筛查参与度。(. 2024;114(S6):S515-S524. https://doi.org/10.2105/AJPH.2024.307733)[公式:见文本]。

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