School of Nursing, The George Washington University, Innovation Hall, 45085 University Drive, Ashburn, VA, 20147, USA.
The George Washington School of Medicine, The Baltimore VA Medical Center, Baltimore, MD, USA.
Support Care Cancer. 2024 Oct 30;32(11):756. doi: 10.1007/s00520-024-08958-6.
Significant disparities exist in cancer detection, treatment, and outcomes for racial/ethnic minoritized groups in the US. The objective of this study was to explore racial/ethnic disparities in healthcare utilization, cancer care experiences, and beliefs about cancer in patients diagnosed with cancer among diverse racial/ethnic groups in the US.
Data from the Health Information National Trends Survey -Surveillance, Epidemiology, and End Results (HINTS-SEER 2021) were analyzed for 1,108 cancer survivors. Bivariate analysis of the study variables with race/ethnicity were conducted with weighted analysis from STATA version 17. Sampling weights using svy was conducted.
Racial/ethnic differences in healthcare utilization remained significant when controlling for the confounding factors. Asians and Hispanics were less likely to have a regular healthcare provider compared to non-Hispanic whites (NHW) (aOR = 3.31, p = .003; aOR = 2.17, p = .014; respectively). Asians were less likely than NHW to have had healthcare provider visits in the past 12 months (aOR = 4.89, p = .011). There were no statistically significant differences between racial/ethnic groups in the cancer care experiences. Racial/ethnic differences in fatalistic beliefs about cancer were not significant in the final multivariate model; however, being older (β = -.41, p = .033), and having a higher education level (β = -1.23, p < .001), were associated with lower level of fatalistic beliefs about cancer.
The findings suggest tailored approaches to improve healthcare utilization rates among racial/ethnic minoritized groups and highlight the need for increased research and clinical practice efforts to address racial/ethnic disparities in the cancer care continuum.
在美国,少数族裔群体在癌症检测、治疗和结果方面存在显著差异。本研究旨在探讨美国不同种族/族裔群体癌症患者的医疗保健利用、癌症护理体验和癌症信念方面的种族/族裔差异。
对来自健康信息国家趋势调查-监测、流行病学和最终结果(HINTS-SEER 2021)的 1108 名癌症幸存者的数据进行了分析。使用 STATA 版本 17 进行了带有种族/族裔的研究变量的双变量分析,并进行了加权分析。使用 svy 进行了抽样权重。
在控制混杂因素后,医疗保健利用的种族/族裔差异仍然显著。与非西班牙裔白人(NHW)相比,亚洲人和西班牙裔人不太可能有固定的医疗保健提供者(aOR=3.31,p=0.003;aOR=2.17,p=0.014)。亚洲人过去 12 个月内接受医疗保健提供者就诊的可能性低于 NHW(aOR=4.89,p=0.011)。种族/族裔群体之间的癌症护理体验没有统计学上的显著差异。在最终的多变量模型中,对癌症的宿命信念的种族/族裔差异并不显著;然而,年龄较大(β=-0.41,p=0.033)和教育程度较高(β=-1.23,p<0.001)与对癌症的宿命信念水平较低相关。
研究结果表明,需要采取有针对性的方法来提高少数族裔群体的医疗保健利用率,并强调需要加强研究和临床实践努力,以解决癌症护理连续体中的种族/族裔差异。