Beatrici Edoardo, Qian Zhiyu, Filipas Dejan K, Stone Benjamin V, Dagnino Filippo, Labban Muhieddine, Lipsitz Stuart R, Lughezzani Giovanni, Buffi Nicolò M, Cole Alexander P, Trinh Quoc-Dien
Department of Urology and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Department of Urology, Humanitas Research Hospital-IRCCS, Milan 20121, Italy.
JNCI Cancer Spectr. 2025 Jan 3;9(1). doi: 10.1093/jncics/pkae127.
Factors associated with cancer survivors' preventive health behaviors are understudied. We hypothesized that socioeconomic and health-care access factors may be associated with adherence to recommended cancer screenings.
We conducted a cross-sectional analysis using the 2020 Behavioral Risk Factor Surveillance System. Cancer survivors eligible for United States Preventive Services Task Force-recommended breast, cervical, prostate, and colorectal screenings were included. Multivariable logistic regression models were used to identify socioeconomic factors significantly associated with screening adherence.
Overall, 64 958 (weighted national estimate = 29 066 143) cancer survivors were included. Adherence rates varied across cancer types: 80.9% for breast, 88.9% for cervical, 54.1% for prostate, and 84.7% for colorectal cancer. Key predictors of low adherence included lower income (breast: adjusted odds ratio [aOR] = 0.56, 95% confidence interval [CI] = 0.43 to 0.74; cervical: aOR = 0.38, 95% CI = 0.24 to 0.59; prostate: aOR = 0.36, 95% CI = 0.24 to 0.52; colorectal: aOR = 0.74, 95% CI = 0.57 to 0.96), lack of health-care coverage for colorectal cancer (aOR = 0.51, 95% CI = 0.36 to 0.73), time since last checkup between 1 and 2 years prior for breast (aOR = 0.58, 95% CI = 0.45 to 0.75), prostate (aOR = 0.66, 95% CI = 0.47 to 0.91), and colorectal (aOR = 0.69, 95% CI = 0.56 to 0.86) cancer, and no health-care provider for breast (aOR = 0.68, 95% CI = 0.47 to 0.98), prostate (aOR = 0.45, 95% CI = 0.31 to 0.65), and colorectal (aOR = 0.51, 95% CI = 0.40 to 0.66) cancer.
Cancer survivors' adherence to screening is associated with factors including lack of health-care coverage, lower income, time since the last exam, and having a personal provider. Targeted interventions accounting for such factors may help mitigate these disparities.
与癌症幸存者预防性健康行为相关的因素研究不足。我们假设社会经济和医疗保健可及性因素可能与遵循推荐的癌症筛查有关。
我们使用2020年行为风险因素监测系统进行了一项横断面分析。纳入了符合美国预防服务工作组推荐的乳腺癌、宫颈癌、前列腺癌和结直肠癌筛查条件的癌症幸存者。多变量逻辑回归模型用于确定与筛查依从性显著相关的社会经济因素。
总体而言，纳入了64958名（加权全国估计数=29066143）癌症幸存者。不同癌症类型的依从率有所不同：乳腺癌为80.9%，宫颈癌为88.9%，前列腺癌为54.1%，结直肠癌为84.7%。低依从性的关键预测因素包括低收入（乳腺癌：调整优势比[aOR]=0.56，95%置信区间[CI]=0.43至0.74；宫颈癌：aOR=0.38，95%CI=0.24至0.59；前列腺癌：aOR=0.36，95%CI=0.24至0.52；结直肠癌：aOR=0.74，95%CI=0.57至0.96）、结直肠癌缺乏医疗保险（aOR=0.51，95%CI=0.36至0.73）、乳腺癌、前列腺癌和结直肠癌上次检查时间在1至2年前（乳腺癌：aOR=0.58，95%CI=0.45至0.75；前列腺癌：aOR=0.66，95%CI=0.47至0.91；结直肠癌：aOR=0.69，95%CI=0.56至0.86），以及乳腺癌、前列腺癌和结直肠癌没有医疗保健提供者（乳腺癌：aOR=0.68，95%CI=0.47至0.98；前列腺癌：aOR=0.45，95%CI=0.31至0.65；结直肠癌：aOR=0.51，95%CI=0.40至0.66）。
癌症幸存者对筛查的依从性与包括缺乏医疗保险、低收入、上次检查时间以及有个人医疗保健提供者等因素有关。考虑到这些因素的针对性干预措施可能有助于减轻这些差异。
